THU0257 Associations between trabecular bone score and vertebral fractures in patients with axial spondyloarthritis. (12th June 2018)

• Record Type: Journal Article
• Authors: Kim, H.R.; Hong, Y.S.; Kang, K.Y.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 347
• Page End: 348
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.1712
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: The bone tissue directly exposed to inflammation in axSpA is the trabecular bone of the vertebrae, and consequently, vertebral osteoporosis and resorption of trabecular bone are increased in axial spondyloarthritis. The trabecular bone score (TBS) is a novel tool used to evaluate bone microarchitecture. AxSpA patients showed poor bone quality compared with matched controls. Objectives: This study aims to compare TBS between axSpA patients with and without vertebral fractures and investigate associations between TBS and vertebral fractures. Methods: Two hundred and fifty-five patients fulfilling the imaging arm of the Assessment of SpondyloArthritis International Society axSpA criteria were enrolled. TBS and bone mineral density (BMD) were assessed using dual-energy X-ray absorptiometry. Vertebral fracture of the thoracic and lumbar spine was defined according to the Genant criteria. Osteoporosis risk factors, inflammatory markers, disease activity scores, and spinal structural damage were also assessed. Multivariate logistic regression analysis was performed to identify factors associated with vertebral fractures. Results: Of 255 axSpA patients, 28 (11%) had 31 vertebral fractures. The mean TBS was 1.39±0.11 and 1.30±0.13 in patients without and with vertebral fractures, respectively (<0.001). BMD in the femoral neck was lower in patients with vertebral fractures (p=0.027), but BMDs in the lumbar spine and total hip were not. In the multivariate analyses, low TBS and the presence of syndesmophytes were significantly associated with vertebral fractures, independently of BMD (OR [95% CI]=3.6 [1.2–11.1] and 3.3 [1.0–10.7], respectively). For the total hip, TBS has a better discriminatory value than BMD for prediction of vertebral fractures in axSpA patients (p=0.034). Conclusions: TBS values are lower in axSpA patients with vertebral fractures. Low TBS and syndesmophytes were independently associated with prevalent vertebral fractures. TBS has better predictive value to BMD for the discrimination of vertebral fractures and could help to detect axSpA patients with vertebral fractures. Disclosure of Interest: None declared