The risk of fractures and the need for anti-osteoporotic treatment in patients with systemic sclerosis

Abstract

Objective: to estimate the high and very high Frax® 10-year probabilities of fractures in patients with systemic sclerosis (SSc) to assess the need for anti-osteoporotic treatment.Patients and methods. The investigation enrolled 136 SSc patients (110 women and 26 men; mean age, 59.3±7.5 years). The patients underwent a questionnaire survey, by calculating the risk of major fractures with the FRAX® algorithm and dual-energy X-ray densitometry (DXA) of the lumbar spine and proximal femur.Results and discussion. There was a very high risk of fractures in 41.2% of the examinees, a high risk in 10.3%, and a low risk in 48.5%. Osteoporosis (OP) in at least one area was detected in 41.2% of the patients. Among the persons with a low risk of fractures, OP was diagnosed in 18.2%, whereas 10.6% had a history of fractures. A total of 65.4% of SSc patients needed anti-osteoporotic treatment.Conclusion. According to the comprehensive assessment, OP treatment and fracture prevention were indicated for 65.4% of SSc patients. The FRAX® algorithm is less informative in males who need therapy than in females.