THU0273 Prevalence of vertebral fractures in ankylosing spondylitis: a meta-analysis. (12th June 2018)

• Record Type: Journal Article
• Authors: Sahuguet, J.; Mancini, J.; Lafforgue, P.; Pham, T.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 355
• Page End: 355
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.5191
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Osteoporosis is a well-recognised feature of ankylosing spondylitis (AS). Patients with AS have an increased risk of vertebral fractures (VF) but prevalence of VF is variable across studies from 4% to 42%. The diagnosis of VF is still problematic because frequently asymptomatic and sometimes difficult to differentiate from vertebral deformities which are not fractures. Objectives: The aim of our study was to determine the prevalence of VF in AS and the risk factors associated. Methods: Two independent investigators conducted a search in Medline and Cochrane databases, including cohorts, cross-sectional, and case-control studies that had assessed the prevalence of VF in patients with AS fulfilling the modified New York criteria. We collected data about study design, demographics, disease activity and severity (HLA B27 antigen status, BASDAI, BASFI, ASDAS, mSASSS, CRP, ESR, treatment history), bone mineral density, method of VF assessment (method of X-rays reading, number of readers) and characteristics of VF (number, prevalence, grade). Results: Among 434 screened studies, 17 were eligible for meta-analysis. The pooled VF prevalence in patients with AS was 19% (95% CI 14%>24%, I 2 90.5%) (figure 1). The CRP (p<0.001) and mSASSS (p=0.046) scores were associated with a higher risk of VF. When focusing only on moderate to severe VF, HLA B27 antigen (p=0.046), lumbar spine osteoporosis (p=0.018) and osteopenia (p=0.024), hip BMD (p=0.024), CRP (p=0.004), ESR (p<0.001), and Genant method (p=0.009) were associated with higher risk of VF. Conclusions: Despite a large heterogeneity among studies, the prevalence of VF in AS patients is high. CRP and mSASSS scores were associated with the prevalence of all VF. Classical VF risk factors, such as osteoporosis, were associated only with moderate and severe VF. Disclosure of Interest: None declared