Psoriasis or Psoriatic Arthritis patients have higher fracture risk, finds study
Taiwan: Evidence regarding the association of bone density, bone fragility or fracture risk with psoriatic disease remains inconclusive.
Researchers have found in a new study that psoriatic disease patients are at higher risk of fractures compared to those without the condition.According to the study, higher fracture risk is not necessarily associated with a higher osteoporosis risk nor lower bone mineral density (BMD).
The study has been published in the Journal of Clinical Medicine.
Psoriatic arthritis (PsA) and cutaneous psoriasis are chronic inflammatory disorders recognized on the spectrum of psoriatic disease. Awareness of psoriasis-related comorbidities has been established in the current guidelines; however evidence on the association of bone fragility or bone density with psoriatic disease remains inconclusive. Therefore, Tai-Li Chen, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan, and colleagues conducted a systematic review and meta-analysis to assess BMD and the risk of osteoporosis and fractures in patients with psoriatic disease, including those with cutaneous psoriasis and psoriatic arthritis.
The researchers searched the online databases for published observational studies. Using the random-effect model, a meta-analysis was performed. Pooled estimates and their confidence intervals (CIs) were calculated. Small-study effects were examined using the Doi plot and Luis Furuya–Kanamori index.
Key findings of the study include:
- The analysis of the standardized mean difference in the absolute value of bone mineral density at different measuring sites (lumbar spine, femoral neck, and total hip) revealed no significant difference between patients with psoriatic disease and non-psoriatic controls.
- The pooled results of the adjusted odds ratios (ORs) demonstrated no increased risk of osteoporosis in patients with psoriatic disease.
- Patients with psoriatic disease had a higher OR of developing bone fractures (adjusted OR: 1.09).
"Our findings demonstrate that patients with psoriatic disease may be more likely to develop fractures compared with non-psoriatic controls. This higher risk for fracture may not necessarily be associated with lower bone mineral density nor a higher risk for osteoporosis," concluded the authors.
"Bone Mineral Density, Osteoporosis, and Fracture Risk in Adult Patients with Psoriasis or Psoriatic Arthritis: A Systematic Review and Meta-Analysis of Observational Studies," is published in the Journal of Clinical Medicine.