Are Psoriasis and PsA Linked to Osteoporosis and Fractures?

Psoriasis and psoriatic arthritis (PsA) are likely associated with osteoporosis, along with osteopenia, ankylosing spondylitis (AS), and pathological fractures, according to a new study.

The researchers conducted a cross-sectional study of nearly 200 million children and adults, using data from the 2006-2012 Nationwide Emergency Department Sample, including 20% of hospital-based emergency care visits across the United States. A total of 183,725 participants had psoriasis, and 28,765 had PsA.
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Participants with psoriasis tended to be older, male, and more likely to have Medicare as a primary payment method. Those with PsA also tended to be older and have Medicare, but sex distribution was similar between males and females.

A pooled analysis indicated that patients with psoriasis faced a much greater risk of developing osteoporosis, osteopenia, osteomalacia, AS, and pathological fractures. Analysis of patients with PsA demonstrated similar results. Additionally, the researchers linked psoriasis to vertebral, pelvic, femoral, and tibial/fibular fractures, and PsA was associated with stress and vertebral, pelvic, femoral, and tibial/fibular fractures.

The results indicated that women with psoriasis or PsA faced a greater risk of developing osteopenia, osteoporosis, and osteomalacia, while the risk of developing AS was greater in men. Additionally, patients with Pso and PsA who experienced fractures tended to show higher rates of hospitalization, prolonged hospitalization, and increased care costs.

“In conclusion, both [psoriasis] and PsA are associated with osteopenia, osteoporosis, osteomalacia, AS, and multiple types of fractures, particularly pathological femoral, vertebral, pelvic, tibia, and fibula fractures,” the researchers concluded. “Further studies are needed to confirm these findings and determine the ideal approaches to prevent and treat these comorbidities.”

—Christina Vogt

Reference:

Kathuria P, Gordon KB, Silverberg JI. Association of psoriasis and psoriatic arthritis with osteoporosis and pathological fractures. J Am Acad Dermatol. 2017;76(6) :1045-1053.e3. http://dx.doi.org/10.1016/j.jaad.2016.11.046.