Status of fracture risk assessment and osteoporosis treatment in Japanese patients with rheumatoid arthritis

Mod Rheumatol. 2021 Sep;31(5):987-991. doi: 10.1080/14397595.2020.1847752. Epub 2020 Nov 20.

Abstract

Objectives: This study aimed to investigate the prevalence of patients with rheumatoid arthritis (RA) at a high risk of major osteoporosis (OP)-related fractures and the status of OP-related medical treatment for these patients.

Methods: We enrolled 120 patients aged ≥40 years (average, 69.1 years) with RA. The Fracture Risk Assessment Tool (FRAX®) was used to evaluate the fracture risk. Of the 120 patients, the femoral neck bone mineral density (BMD) was evaluated in 102 patients, and their FRAX® scores were calculated alongside the BMD values. Patients observed to be at a high risk of a major OP-related fracture (10-year probability >20% or hip fracture risk >3%), according to FRAX®, were identified as those requiring OP treatment; medication ratio for OP (percentage of patients actually receiving medication among patients requiring OP treatment) was assessed.

Results: OP treatment was indicated in 75 (63%) patients; the medication ratio for OP was 49%. The use of biological disease-modifying anti-rheumatic drugs and corticosteroids showed a positive effect; however, the use of methotrexate showed a negative effect on the medication ratio.

Conclusion: The number of potential patients requiring OP treatment is underestimated. All patients with RA should be assessed to determine their eligibility for OP treatment.

Keywords: FRAX; medication ratio; osteoporosis; rheumatoid arthritis.

MeSH terms

  • Absorptiometry, Photon
  • Adult
  • Aged
  • Arthritis, Rheumatoid* / complications
  • Arthritis, Rheumatoid* / drug therapy
  • Arthritis, Rheumatoid* / epidemiology
  • Bone Density
  • Humans
  • Japan / epidemiology
  • Osteoporosis* / chemically induced
  • Osteoporosis* / diagnosis
  • Osteoporosis* / drug therapy
  • Osteoporotic Fractures / chemically induced
  • Osteoporotic Fractures / epidemiology
  • Risk Assessment
  • Risk Factors