Abstract
THE RISK OF OSTEOPOROTIC FRACTURES ACCORDING TO THE FRAX MODEL IN RHEUMATOID ARTHRITIS PATIENTS IN SLEMANI PROVINCE

Dr. Raouf R. Mirza*

ABSTRACT

Background: Rheumatoid arthritis is a chronic systemic autoimmune disease, joint inflammation is induced primarily by autoreactive immune cells and the overproduction of proinflammatory cytokines which mediate long term cartilage degradation and bone erosion and may increase the risk of osteoporosis and fracture. Objectives: To determine if FRAX calculations without BMD (FRAX) and with BMD (FRAX/ BMD) would produce identical predictions for the 10-year probability of hip fracture and other major osteoporotic fractures; and to assess the effect of smoking on the prediction on that risk. Patients and methods: A prospective study carried out in a convenient sample of 153 RA patients selected from RA patients were categorized into two groups one group (53 RA patients assessed by FRAX with BMD) and another (100 RA patients assessed by FRAX without BMD). Results: Prediction of major osteoporotic fracture for RA patients assessed by FRAX without BMD was <10% in 65% , 10- 20% in 22% and >20% in 13% . Prediction of hip fractures for RA patients assessed by FRAX without BMD was <3% in 66% , 3-10% in 27% and >10% in 7% of them. Prediction of major osteoporotic fracture for RA patients assessed by FRAX with BMD revealed that mean percentage was 17.5±14.8 %, 37.7% of them <10%, 37.7% of them 10-20% and 24.5% of them >20%. Prediction of hip fractures was <3 for 43.4% of RA patients assessed by FRAX with BMD, 3-10% for 34% and >10% for 22.6% of them. Conclusion The results indicated that here is significant association between predictions of major osteoporotic fractures (<10% ) and RA patients assessed by FRAX without BMD, and for hip fractures >10% and RA patients assessed by FRAX with BMD, ). Smoking of RA patients in present study was significantly risk factor for high prediction of osteoporotic fractures detected by both methods (with or without BMD).

Keywords: Rheumatoid arthritis, FRAX, Osteoporosis.


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