Screening rates and prevalence of osteoporosis in a real‐world, Australian systemic sclerosis cohort

• Published in: International journal of rheumatic diseases 2022-02, Vol.25 (2), p.175-181
• Main Authors: Bimal, Gayathri, Sahhar, Joanne, Savanur, Monika, Ngian, Gene‐Siew
• Format: Article
• Language: English
• Subjects: Absorptiometry, Photon - statistics & numerical data; Aged; Australia; Australia - epidemiology; Bone density; Bone mineral density; Calcinosis; Dual energy X-ray absorptiometry; Female; Fractures; Humans; Intravenous administration; Male; Middle Aged; Myositis; Nasogastric feeding; Osteopenia; Osteoporosis; Osteoporosis - diagnosis; Osteoporosis - epidemiology; Ostomy; Parenteral nutrition; Patients; Prednisolone; Prevalence; Retrospective Studies; Scanning; Scleroderma; Scleroderma, Systemic - epidemiology; Scleroderma, Systemic - physiopathology; screening; Spine (lumbar); Synovitis; Systemic sclerosis
• ISSN: 1756-1841; 1756-185X
• DOI: 10.1111/1756-185X.14254

Aim Despite reports of decreased bone mineral density in patients with systemic sclerosis (SSc) in international cohorts, the prevalence of osteoporosis in Australian SSc patients remains unknown. We report rates of dual‐energy X‐ray absorptiometry (DXA) scanning in an SSc cohort at a tertiary hospital specialized outpatient clinic and the prevalence and associations of osteoporosis in screened patients. Method We performed retrospective chart review to determine if patients underwent DXA scanning between 2007 and 2018 and extracted lumbar spine and femoral neck T‐scores, fracture history, and osteoporosis therapy. Results Of 244 patients, 104 (42.6%) underwent DXA scanning and among patients in whom T‐scores were available (n = 91), 30 (33.0%) had osteoporosis and 48 (52.7%) had osteopenia. Screened patients were more likely to have longer disease duration (19.9 vs 15.2 years, P = 0.002), calcinosis (50.5% vs 36.4%, P = 0.028), myositis (12.6% vs 0.7%, P < 0.001), synovitis (42.7% vs 28.6%, P = 0.022), ever used prednisolone (76.7% vs 47.1%, P < 0.001) or fractures (23.0% vs 0.0%, P < 0.001). Patients with osteoporosis more commonly had a history of nasogastric feeding, percutaneous endoscopic gastrostomy feeding or intravenous total parenteral nutrition (6.9% vs 0.0%, P = 0.038) and, unexpectedly, less commonly ever used prednisolone (58.6% vs 85.2%, P = 0.005) compared with patients with osteopenia or normal bone density. Conclusion We identified high rates of osteoporosis among screened Australian SSc patients. Further assessment in larger, prospective studies is needed to establish guidelines for formal osteoporosis screening in SSc patients.