TUESDAY, Jan. 3 (HealthDay News) -- For patients with systemic lupus erythematosus (SLE), the etiology of osteoporosis is multifactorial, encompassing traditional risk factors and SLE-related factors; and there is an increased fracture risk, according to a review published in the January issue of Arthritis Care & Research.
Irene E.M. Bultink, M.D., Ph.D., from the VU University Medical Center in Amsterdam, Netherlands investigated the etiology of bone loss and fractures in patients with SLE, and reviewed measures for the prevention and treatment of these complications.
The investigator found that osteopenia was reported in 25 to 74 percent, and osteoporosis in 1.4 to 68 percent, of patients with SLE. The etiology was multifactorial, including traditional risk factors, as well as inflammation; medication-induced adverse events; and metabolic, hormonal, and serologic factors. In a population-based cohort, fracture occurrence was nearly five-fold higher in women with SLE. Risk factors for symptomatic fractures included age, postmenopausal status, disease duration, and reduced bone mineral density (BMD). Glucocorticoid treatment is predictive of osteoporotic fractures, with increased duration of use linked with the time from SLE diagnosis to fracture. Vertebral fractures are prevalent in 20 to 26.1 percent of patients with SLE; and 20 to 35.8 percent of these patients had normal BMD. Lifestyle measures, adequate calcium intake and serum levels, and prescription of immunosuppressive medications to reduce inflammation-induced bone loss are recommended for prevention and treatment of osteoporosis and fractures.
"Additional vertebral fracture assessment must be considered since vertebral fractures are frequent in SLE," the author writes. "Moreover, osteoporosis screening should also be considered in subgroups of SLE patients without glucocorticoid treatment."
Abstract
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