POS0857 REMARKING THE OSTEOPOROSIS IN PATIENTS WITH ANCA-ASSOCIATED VASCULITIS (AAV): DATA FROM EASTERN MEDITERRANEAN (TRVAS)
Authors: T. Demirci Yildirim, E. Erpek, B. Özdemir Ulusoy, E. Ünaldi, O. Sadioglu Cagdas, R. C. Kardaş, D. Sahin, D. Ozgur, R. Yildirim, M. Kiziltepe, P. Akyüz Dağli, O. Kipri, A. Ilbay, A. Babayigit, E. Durak Ediboglu, E. C. Bolek, H. Kocaayan, G. Ayan, B. Bulat, G. Sandal Uzun, B. Armagan, G. Kenar, E. Uslu Yurteri, A. Erden, H. Küçük, A. Sahin, C. Bes, A. Yazici, Ş. A. Bilgen, F. Alibaz- Oner, M. E. Tezcan, O. Karadag, A. Omma, S. Akar, F. Onen
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Osteoporosis is a common health condition that affects 20-30% of AAV (anti-neutrophil cytoplasmic antibody-associated vasculitis) patients [1]. However, not much research has been done on this issue in the Eastern Mediterranean Region. <h3>Objectives:</h3> This study aimed to investigate the level of awareness of osteoporosis among rheumatologists who treat AAV patients in a prospective nationwide cohort in Turkey. <h3>Methods:</h3> Data from the Turkish Vasculitis Study Group (TRVaS) registry were screened and analyzed for AAV patients who had any prior dual x-ray absorptiometry (DXA) examination. Osteoporosis was defined according to the World Health Organization (WHO) criteria as a bone mineral density (BMD) ≤-2.5 standard deviation (SD) of the mean of young adults and osteopenia was defined as BMD ≤− 1.0 SD and &gt;− 2.5 SD [2]. Demographic and clinical characteristics were recorded in a case report form in which osteoporosis and its treatment were evaluated in detail. <h3>Results:</h3> A total of 528 AAV patients (GPA= 369, MPA= 67, EGPA= 46, and unclassified AAV= 46) were included in the study; 305 (57.8%) were male, and the median age was 56 years (interquartile range, IQR, 43-66). Median disease duration was found to be 33 months (IQR, 10-72). DXA was performed in a total of 191 (36.2%) patients during their follow-up, and in 53 (10.0 %) at the time of AAV diagnosis. Patients scanned with DXA had similar demographic and clinical characteristics compared with unscreened patients (n=337), except for disease duration (median, 22 vs. 46 months, p&lt;0.001 respectively). Osteoporosis was diagnosed in 78 (40,8 %) patients and osteopenia in 74 (38.7%). Only 39 (20.4%) patients had normal BMD. Patients with osteoporosis were older (median, 64 vs 54 years, p&lt;0.002) and had lower body weight (median, 68 vs 74 kg, p=0.03) compared to patients without osteoporosis. The causes of secondary osteoporosis in patients and the immunosuppressive treatments used are shown in Table 1. The frequency of osteoporotic bone fractures in patients with osteoporosis was numerically higher than in patients without osteoporosis (11.5% vs. 7.1%, p=0.249). The median 25-OH vitamin D level was lower in patients with osteoporosis than in patients without osteoporosis, but the difference was not statistically significant (23 vs. 28 ng/ml, p=0.157). Oral or IV bisphosphonate was administered to 64.1% of patients with osteoporosis, and denosumab was administered to 7.7%. Only 10.8% of patients with osteopenia used oral bisphosphonate. <h3>Conclusion:</h3> This study showed that osteoporosis was investigated in only one-third of patients with AAV in this cohort, and most DXA scans were conducted within the first three years of follow-up instead of at the beginning of treatment. It also suggested that the prevalence of osteoporosis in AAV patients was much higher (80%) compared to the general population. Physicians should consider the evaluation and treatment of secondary osteoporosis in the management of AAV to decrease the risk of osteoporotic fracture, a severe comorbidity. <h3>REFERENCES:</h3> [1] Mercuzot C, Letertre S, Daien CI, Zerkowski L, Guilpain P, Terrier B, Fesler P, Roubille C. Comorbidities and health-related quality of life in Patients with Antineutrophil Cytoplasmic Antibody (ANCA) - associated vasculitis. Autoimmun Rev. 2021 Jan;20(1):102708. doi: 10.1016/j.autrev.2020.102708. Epub 2020 Nov 17. PMID: 33212227. [2] Kanis, John A. "World Health Organization Collaborating Centre for Metabolic Bone Diseases." <i>University of Sheffield</i> (2007): 66. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>