Plenary Poster 33rd ASM of the Australian & New Zealand Bone & Mineral Society 2023

Abstract

Background: Rheumatoid Arthritis (RA) patients have a higher risk of developing osteoporosis, which increases morbidity, mortality rates, and healthcare costs [1]. There is limited data on the prevalence of osteoporosis and associated risk factors in RA.

Objectives: Estimate the global prevalence of osteoporosis in RA patients, identify associated risk factors, and determine high-risk RA patients who require preventive osteoporosis treatment.

Methods: We conducted a search in several databases (MEDLINE, Scopus, ProQuest Central, Web of Science, EMBASE, CINAHL, and Google Scholar) to estimate the global prevalence of osteoporosis in RA populations. We also evaluated the influence of geographical location, prevalence methods, and diagnostic criteria on prevalence estimates from 1980 to 2023.

Results: We included 29 studies involving 31,473 RA patients with osteoporosis out of 130,989 RA populations. The global prevalence of osteoporosis in RA was estimated to be 21.5% (95% confidence interval 16.5-27.0), with a prediction interval of 1.4% - 56.1% (Figure 1). The point-prevalence of osteoporosis was 19.2% (95% CI 13.3-25.8), while the period-prevalence was 27.1% (95% CI 18.9-36.3). The highest pooled prevalence of osteoporosis was observed in Asia (30.0%; 95% CI 22.1-38.6), while Europe (13.4%; 95% CI 8.9-18.7) and North America (13.3%; 95% CI 11.0-15.9) had lower estimates. Factors influencing osteoporosis prevalence included continents, prevalence methods, and diagnostic osteoporosis criteria. The World Health Organization (WHO) osteoporosis criteria exhibited greater consistency in prevalence estimates in RA populations, regardless of demographic characteristics.

Conclusion: The estimated global point- and period-prevalence of osteoporosis in RA were 19.2% and 27.1%, respectively. Higher prevalence rates observed in Asia may be influenced by restricted healthcare access or variations in risk environments, highlighting the significance of the WHO criteria in predicting and guiding preventive treatment.