Ukrainian version of FRAX in fracture risk assessment for women with rheumatoid arthritis

Abstract

Nowadays, the numerous studies confirm an increased fractures risk in the rheumatoid arthritis (RA) patients. FRAX is informative tool for fracture risk assessment; however, data about its use in patients with RA are limited. The aim of this study was to determine the 10-year probability of major osteoporotic fractures and hip fractures of the RA female patients by means of the Ukrainian FRAX version. We have performed a cross-sectional case-control study, examining 794 women aged 40–89 years that were divided in two groups: І (n = 397) – healthy subjects without RA and ІІ (n = 397) – patients with a verified RA diagnosis. The appraisal of major osteoporotic fracture risk and hip fracture one was made according to the Ukrainian model of FRAX without and with bone mineral density (BMD) measurement. This study demonstrated that the RA patients have significantly higher FRAX values, compared to healthy subjects both in the total group and in different age subgroups. There was a strong correlation between the FRAX values with/out the BMD in the RA patients (r = 0.75). About 40 % of the RA patients require antiosteo porotic treatment even without DXA results, based exclusively on the FRAX values, and about 47 % more require a revision of fracture risk after the BMD measurement. Additionally, only 7 % of patients require osteoporosis treatment revision after BMD measurement. All the above-mentioned facts should be considered while managing this category of patients in order to reduce the risk of osteoporotic fractures.