Article: article from journal or magazin.
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Official Positions for FRAX® clinical regarding rheumatoid arthritis from Joint Official Positions Development Conference of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX®.
Journal of Clinical Densitometry
FRAX(®)Position Development Conference Members
Hans DB., Cooper C., Baim S., Dawson-Hughes B., Kanis JA., Leslie WD., Luckey MM., Rizzoli R., Poiana C., Bilezekian JP., Papapoulos SE., McCloskey EV., Binkley N., Adachi JD., Baim S., Blank RD., Boonen S., Broy SB., Bruyere O., Chandran M., Cooper C., Dawson-Hughes B., Eastell R., Ensrud K., Dimai HP., Foldes J., Garnero P., Geusen PP., Griesmacher A., Hannan MT., Kanis JA., Kleerekoper M., Krieg MA., Langdahl B., Laster A., Leib ES., Masud T., McClung M., Morris H., Ortolani S., Saag KG., Siris E., Silverman S., Bobo Tanner S., Trenti T., Vasikaran S., Vestergaard P., Wahl DA., Michael Lewiecki E., Compston JE., Adachi JD., Adams JE., Adler RA., Bauer DC., Blake GM., Clark P., Diez-Perez A., Hans DB., Josse RG., Kanis JA., Kendler DL., Khan AA., Krieg MA., Leslie WD., Lorenc RR., Moayyeri A., Masri BK., Miller PD., Cauley JA., Fuleihan el-HG., Arabi A., Calderon A., Chen Z., Chionh SB., Curtis J., Danielson ME., Fujiwara S., Hanley D., Kroger H., Kung A., Lesnyak O., Looker A., Luckey MM., Mellstrom D., Nieves J., Pluskiewicz W., Rassi RE., Rizzoli R., Ragi-Eis S., Silverman S., Schott-Pethelaz A., Bilezekian JP., Papapoulos SE., Adachi JD., Blank RD., Chapurlat R., Chih-Hsing W., Czerwinski E., Perez AD., Dimai HP., Fuleihan el-HG., Fujiwara S., Ionescu RM., Kanis JA., McClung M., Stepan J., Ragi-Eis S., Saag KG., Schousboe JT., Yu W., Zerbini C., Brown PD., McKenney P., Johansson H., Nagy J., Oden A., Wahl DA.
Publication types: Consensus Development Conference ; Journal Article
Publication Status: ppublish
Publication Status: ppublish
Rheumatoid arthritis is the only secondary cause of osteoporosis that is considered independent of bone density in the FRAX(®) algorithm. Although input for rheumatoid arthritis in FRAX(®) is a dichotomous variable, intuitively, one would expect that more severe or active disease would be associated with a greater risk for fracture. We reviewed the literature to determine if specific disease parameters or medication use could be used to better characterize fracture risk in individuals with rheumatoid arthritis. Although many studies document a correlation between various parameters of disease activity or severity and decreased bone density, fewer have associated these variables with fracture risk. We reviewed these studies in detail and concluded that disability measures such as HAQ (Health Assessment Questionnaire) and functional class do correlate with clinical fractures but not morphometric vertebral fractures. One large study found a strong correlation with duration of disease and fracture risk but additional studies are needed to confirm this. There was little evidence to correlate other measures of disease such as DAS (disease activity score), VAS (visual analogue scale), acute phase reactants, use of non-glucocorticoid medications and increased fracture risk. We concluded that FRAX(®) calculations may underestimate fracture probability in patients with impaired functional status from rheumatoid arthritis but that this could not be quantified at this time. At this time, other disease measures cannot be used for fracture prediction. However only a few, mostly small studies addressed other disease parameters and further research is needed. Additional questions for future research are suggested.
Algorithms, Antirheumatic Agents/adverse effects, Antirheumatic Agents/therapeutic use, Arthritis, Rheumatoid/complications, Arthritis, Rheumatoid/drug therapy, Bone Density, Diagnosis, Computer-Assisted, Fractures, Spontaneous/diagnosis, Fractures, Spontaneous/etiology, Glucocorticoids/adverse effects, Glucocorticoids/therapeutic use, Humans, Models, Statistical, Risk Assessment, Risk Factors
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