1. Risks of femoral localized periosteal thickening in patients with autoimmune inflammatory rheumatic diseases.
- Author
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Sato, Hiroe, Kondo, Naoki, Takai, Chinatsu, Kurosawa, Yoichi, Hasegawa, Eriko, Wakamatsu, Ayako, Kobayashi, Daisuke, Nakatsue, Takeshi, Abe, Asami, Kazama, Junichiro James, Kuroda, Takeshi, Ito, Satoshi, Ishikawa, Hajime, Endo, Naoto, and Narita, Ichiei
- Subjects
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RHEUMATISM , *FEMORAL fractures - Abstract
Objectives: The incidence of femoral localized periosteal thickening (LPT), which can precede atypical femoral fracture (AFF), is not low (1-10%) in Japanese patients with autoimmune inflammatory rheumatic diseases (AIRDs). We explored the associations between underlying AIRDs and the prevalence of LPT. Methods: We conducted post hoc analyses of two cohorts that included a total of 280 Japanese women, 105 of whom had AIRDs and had been taking bisphosphonate (BP) and prednisolone (PSL) and 175 of whom had rheumatoid arthritis (RA). Results: LPT was detected in a total of 18 patients (6.4%) and 3 (1.1%) developed AFFs. RA was negatively correlated with LPT. A disease other than RA requiring glucocorticoid treatment, BP use ≥5 years, PSL use ≥7 years, and a PSL dose ≥5.5 mg/day were positively correlated with LPT. After adjusting for age, diabetes mellitus, and BP duration or daily PSL dose, RA was no longer associated with LPT. Conclusions: LPT in Japanese patients with AIRDs was associated with BP and glucocorticoid treatment rather than underlying AIRDs. When PSL dose ≥5.5 mg/day is required long-term [typically combined with long-term BP treatment (≥5 years)], clinicians need to pay particular attention in cases LPT and AFF as well as glucocorticoid-induced osteoporosis. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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