Glucocorticoid Cumulative Dose Has No Effect on BMD, Fracture Risk in Psoriasis, PsA

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Glucocorticoid Cumulative Dose Has No Effect on BMD, Fracture Risk in Psoriasis, PsA

A common psoriasis treatment appears to have the all-clear for bone health.

Cumulative glucocorticoid dose appears to have no measurable effect on bone mineral density (BMD) and risk for osteoporotic fractures in patients with psoriasis and psoriatic arthritis (PsA), according to study results reported at the European League Against Rheumatism (EULAR) Congress,  held June 13 to 16, 2018 in Amsterdam.

Current reports on prevalence of osteoporosis and osteoporotic fractures in this population are not abundant and have been contradictory. In order to better understand potential risk factors for fractures, researchers evaluated data from 55 patients with psoriasis or PsA as part of the ongoing Rh-GIOP clinical trial (Glucocorticoid-induced Osteoporosis in Patients With Chronic Inflammatory Rheumatic Diseases or Psoriasis; ClinicalTrials.gov Identifier: NCT02719314). The investigators sought to explore the potential roles of glucocorticoid dose, smoking, and vitamin D status in fracture risk.

Overall, 69% of the patient population included in the study were women, with a mean age of 60 years. Mean disease duration was 16±13 years; patients generally had good functional status as measured by the Health Assessment Questionnaire. Osteoporosis and osteopenia were present in 70% of patients with psoriasis and in 45% of patients with PsA, and osteoporotic fractures were present in 33% of the total cohort. Notably, family history of osteoporosis was positive in 20% of all patients. In addition, 27% and 32% of patients were current or former smokers, respectively, and 60% of all patients had vitamin D levels <75 mmol/l.

Overall, 27% of patients in the cohort were treated with glucocorticoids, with a mean daily dose of 3±8 mg, and a mean cumulative dose of 10.9±20.3 g. The investigators observed no significant difference in BMD between patients with a cumulative glucocorticoid dose >10 g vs <10 g.

Read on: Glucocorticoid Cumulative Dose Has No Effect on BMD, Fracture Risk in Psoriasis, PsA

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