AB0833 BONE TURNOVER MARKERS – DO THEY HAVE A ROLE AS PREDICTORS OF MORTALITY AND NEW FRACTURE IN PATIENTS WITH FRAGILITY HIP FRACTURE?. (June 2019)

• Record Type: Journal Article
• Authors: Guerra, Miguel; Ganhão, Sara; Aguiar, Francisca; Ferreira, Raquel; Martins-Rocha, Teresa; águeda, Ana Filipa; Terroso, Georgina; Vaz, Carlos; Costa, Lúcia
• Is Part Of: Annals of the rheumatic diseases. Volume 78(2019)Supplement 2
• Page Start: 1886
• Page End: 1887
• Publication Date: 2019-06
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2019-eular.632
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: In Osteoporosis (OP), bone turnover markers (BTM) are potential monitors of drug adherence/efficacy as well as predictors of bone loss and fracture risk. However, without solid evidence, international guidelines still do not recommend their systematic measurement to assist treatment decision and follow-up. Objectives: To evaluate the predictive value of baseline BTM (beta crosslaps – bCL; osteocalcin – OC) in the outcome (death and/or new fracture) of patients that suffered a fragility hip fracture (FHF). Methods: Patients referred to a Fracture Liaison Service from March 2015 until March 2017 with a FHF were considered for this study. Clinical/demographic variables were collected, including: age at time of fracture, sex, serum OC and serum bCL at baseline and outcome (death, new fracture, lost to follow-up) until January 2018. Cox regression analysis was used to calculate hazard ratios (HR) for values of OC and bCL; p<=0.05 was considered statistically significant. Results: From a total of 522 patients, 218 presented a baseline measurement of OC and/or bCL and were included for analysis. Table 1 summarizes clinical and demographic characteristics of the sample. Twenty seven patients died (median days until death=457, min 160, max 1049) and 18 had a new fracture (median days until refracture 343.5, min 30, max 835); 129 patients maintained follow-up. Median serum bCL was 0.71 ng/ml (0.12-3.28, n=217) and median OC was 28.2 ng/ml (6.80-198.60, n=215). Through univariate analysis, higher bCL values predicted worse survival outcome (HR=3.09; 95% CI=1.14-8.39;p=0.026), even after adjustment for age/sex (HR=4.28; 95% CI=1.48-12.29;p=0.007); however, it did not predict higher risk of new fracture (HR=3.00;95%CI=0.85-10.68;p=0.089). Serum OC levels showed no statistically significant results, neither for mortality (HR=1.01; 95% CI=0.99-1.03;p=0.341) nor new fracture (HR=1.01;95%CI=0.99-1.04;p=0.057). Conclusion: In this cohort, increased serum levels of bCL predicted higher mortality risk. These results support the value of BTM in OP, strengthening their potential as prognostic markers, besides treatment monitors. Reference: [1] Glendenning P, Chubb SAP, Vasikaran S. Clin Chim Acta. 2018Jun;481:161-170. Disclosure of Interests: None declared