Association of psoriasis and psoriatic arthritis with osteoporosis and pathological fractures
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.Limitations
Data on severity and treatments of Pso were not available.Conclusion
Pso and PsA were associated with osteopenia, osteoporosis, ankylosing spondylitis, and pathologic fractures.