Association of psoriasis and psoriatic arthritis with osteoporosis and pathological fractures.
BACKGROUND
Previous studies examining the relationship between psoriasis (Pso), osteoporosis, and pathological fractures found conflicting results.


OBJECTIVE
To determine whether Pso and psoriatic arthritis (PsA) are associated with osteoporosis and fractures in US adults.


METHODS
Cross-sectional study of 198,102,435 children and adults, including 183,725 with Pso and 28,765 with PsA from the 2006-2012 National Emergency Department Sample, including 20% of the emergency care visits throughout the United States.


RESULTS
In a pooled analysis across all 7 years, patients with Pso had significantly higher odds (multivariate logistic regression; odds ratio, 95% confidence intervals) of diagnosis with osteopenia (2.86, 2.70-3.02), osteoporosis (2.97, 2.89-3.06), osteomalacia (4.40, 2.50-7.74), ankylosing spondylitis (13.34, 12.02-14.81), and pathological fractures (2.35, 2.19-2.53). Similar associations were observed for PsA. Pso was also associated with vertebral (1.17, 1.09-1.25), pelvic (1.18, 1.06-1.31), femoral (1.68, 1.60-1.78), and tibial/fibular fractures (1.28, 1.16-1.41). Whereas, PsA was associated with stress (2.87, 1.08-7.64) and vertebral (1.45, 1.24-1.70), pelvic (1.75, 1.41-2.18), femoral (2.07, 1.85-2.32), and tibial/fibular (1.60, 1.28-2.01) fractures.


CONCLUSIONS
Data on severity and treatments of Pso were not available.


CONCLUSIONS
Pso and PsA were associated with osteopenia, osteoporosis, ankylosing spondylitis, and pathologic fractures.
Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Parul
P
Kathuria
Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Kenneth B
KB
Gordon
Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Electronic address: JonathanISilverberg@gmail.com.
Jonathan I
JI
Silverberg
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015535:Arthritis, Psoriatic / Q000150:complications*; D003430:Cross-Sectional Studies; D005260:Female; D005598:Fractures, Spontaneous / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology / Q000209:etiology*; D011565:Psoriasis / Q000150:complications*; D018570:Risk Assessment; D055815:Young Adult
ankylosing spondylitis; burden; comorbidities; cost of care; emergency care; hospitalization; length of stay; osteomalacia; osteopenia; osteoporosis; psoriasis; psoriatic arthritis; urgent care