Objectives Through the Programme of the Russian Association of Rheumatology for the diagnosis, prevention and treatment osteoporosis (OP) in patients with RA we evaluated the ten year probability of major osteoporotic fracture by FRAX for Russia in patients with RA, and identified prevalence osteoporosis treatment in patients with high or low risk of osteoporotic fractures (OF).
Methods Trough the Programme of a large amount of patients with RA from 12 clinical centers in Russia 560 patients aged 41 to 89 years were selected and have been evaluated the risk of OF by FRAX.
Results 485 (87%) women and 75 (13%) men were involved in our study. Female average age was 60,46 years, male one was 60,1 years. OP was diagnosed in 97 (17%) patients, 74 (13%) had a history of OF, however, of these people OP treatment was approved only 86 (87%) and 36 (49%), respectively. 185 (33%) patients have indications to approve OP treatment, defined using FRAX, only 57 (31%) of these people treatment was imposed. Assignment of treatment didn't need for 375 (67%) patients, however treatment was approved 48 (13%) from them. 77 (73%) patients were taking prescribed medications, 49 (60%) of them – bisphosphonates plus calcium and/or vitamin D supplementation, 14 (18%) – calcium and vitamin D, 11 (14%) – calcitonin, 3 (4%) - strontium ranelate. Osteoporosis evaluation (DXA) was performed in 421 (75%) patients, including 54 (72%) patients with history of OF and 128 (69%) patients with indications to approve OP treatment, defined using FRAX.
Conclusions Osteoporosis management is not quite enough in patients with RA in Russia. There is substantial variation in the quality of risk evaluation of the osteoporotic fractures, osteoporosis evaluation and treatment. Introduction of FRAX for allocation of group of patients with RA with a high risk of fracture will contribute to a personalized approach to approving treatment.
Disclosure of Interest None declared