title: Prevalence of vertebral fractures in patients with rheumatoid arthritis: revisiting the role of glucocorticoids.
abstract: CONCLUSIONS
  Vertebral fracture assessment (VFA) is a convenient tool for the diagnosis of vertebral fracture in RA. Optimal control of inflammation may be an effective means to protect against vertebral fractures.
  
  
  BACKGROUND
  The aim of this case-control study was to assess the prevalence of vertebral fractures (VFs) in patients with RA using VFA technology.
  
  
  METHODS
  Consecutive women (N = 101, 56.1 ± 14.2 years) with RA (mean disease duration, 14.9 ± 10 years) were recruited in the study. Clinical and biological statuses and treatments including glucocorticoids were assessed. Controls (N = 303), randomly selected from the general population, were individually matched to each case for age.
  
  
  RESULTS
  The prevalences of osteoporosis were 55.4% and 10.5% in patients and controls, respectively. Among the subjects, 21.7% and 4.2% had a vertebral fracture in the RA and control groups, respectively. Compared with controls, patients with RA had an increased risk of VFs: odds ratio (OR) (CI 95%) adjusted on body mass index was 6.5 (3.1, 13.9). In a multiple logistic regression analysis, VFs were independently associated with presence of non-vertebral fractures (OR = 9.2 [2.5-33.5]), presence of a fall in the previous year (OR = 4.6 [1.2-18.3]), current use of disease-modifying anti-rheumatic drugs (DMARDs) (OR = 0.05 [0.004, 0.51]) and current use of steroids (OR = 0.17 [0.04, 0.67]).
  
  
  CONCLUSIONS
  Rheumatoid arthritis is a risk factor of VF (OR = 6.5). VFA is a convenient tool for this diagnosis. Presence of VF is inversely related to the use of DMARD and glucocorticoids, enhancing the hypothesis that an appropriate control of the disease may be a protective factor against bone fragility.
authors.affiliation: Rheumatology Department, Cochin Hospital, Paris-Descartes University, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Ghazi
authors.forename: S
authors.initials: S
authors.lastname: Kolta
authors.forename: K
authors.initials: K
authors.lastname: Briot
authors.forename: J
authors.initials: J
authors.lastname: Fechtenbaum
authors.forename: S
authors.initials: S
authors.lastname: Paternotte
authors.forename: C
authors.initials: C
authors.lastname: Roux
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000058:Accidental Falls; D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D015519:Bone Density / Q000502:physiology; D016022:Case-Control Studies; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000209:etiology / Q000503:physiopathology; D012307:Risk Factors; D016103:Spinal Fractures / Q000209:etiology* / Q000503:physiopathology
chemical_list: D018501:Antirheumatic Agents; D005938:Glucocorticoids