CAPÍTULO 7: Comorbilidades y riesgo de cáncer en pacientes con espondiloartitis axial
Resumen
Los pacientes con espondiloartritis axial (EspAax) presentan mayor riesgo de comorbilidades que la población general, las cuales pueden ocurrir de forma aislada o como consecuencia de la actividad inflamatoria sistémica y/o el tratamiento de la misma1. Las comorbilidades en estos pacientes se asocian a un mayor deterioro de la calidad de vida, peores resultados clínicos y respuesta al tratamiento, disminución de la actividad laboral, mayor mortalidad y aumento en los costos de salud. Entre las comorbilidades más frecuentes en los pacientes con EspAax se encuentran: la enfermedad cardiovascular (CV) y sus factores de riesgo (hipertensión, obesidad y síndrome metabólico), los trastornos psiquiátricos (como depresión y ansiedad), las enfermedades neoplásicas y la osteoporosis.Citas
I. Bremander A, Petersson IF, Bergman S, Englund M. Population-based estimates of common comorbidities and cardiovascular disease in ankylosing spondylitis. Arthritis Care Res (Hoboken). 2011;63(4):550-6.
II. Essers I, Stolwijk C, Boonen A, De Bruin ML, Bazelier MT, de Vries F, et al. Ankylosing spondylitis and risk of ischaemic heart disease: a population-based cohort study. Ann Rheum Dis. 2016;75(1):203-9.
III. Zhao SS, Robertson S, Reich T, Harrison NL, Moots RJ, Goodson NJ. Prevalence and impact of comorbidities in axial spondyloarthritis: systematic review and meta-analysis. Rheumatology (Oxford). 2020;59(Suppl4):iv47-iv57.
IV. Agca R, Heslinga SC, Rollefstad S, Heslinga M, McInnes IB, Peters MJ, et al. EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. Ann Rheum Dis. 2017;76(1):17-28.
V. Toussirot E. The Risk of Cardiovascular diseases in axial spondyloarthritis. Current Insights. Front Med (Lausanne). 2021;8:782150.
VI. Han C, Robinson DW, Jr., Hackett MV, Paramore LC, Fraeman KH, Bala MV. Cardiovascular disease and risk factors in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. J Rheumatol. 2006;33(11):2167-72.
VII. Bengtsson K, Forsblad-d'Elia H, Lie E, Klingberg E, Dehlin M, Exarchou S, et al. Are ankylosing spondylitis, psoriatic arthritis and undifferentiated spondyloarthritis associated with an increased risk of cardiovascular events? A prospective nationwide population-based cohort study. Arthritis Res Ther. 2017;19(1):102.
VIII. Szabo SM, Levy AR, Rao SR, Kirbach SE, Lacaille D, Cifaldi M, et al. Increased risk of cardiovascular and cerebrovascular diseases in individuals with ankylosing spondylitis: a population-based study. Arthritis Rheum. 2011;63(11):3294-304.
IX. Moltó A, Etcheto A, van der Heijde D, Landewé R, van den Bosch F, Bautista Molano W, et al. Prevalence of comorbidities and evaluation of their screening in spondyloarthritis: results of the international cross-sectional ASAS-COMOSPA study. Ann Rheum Dis. 2016;75(6):1016-23.
X. Mathieu S, Pereira B, Soubrier M. Cardiovascular events in ankylosing spondylitis: an updated meta-analysis. Semin Arthritis Rheum. 2015;44(5):551-5.
XI. González Mazón I, Rueda-Gotor J, Ferraz-Amaro I, Genre F, Corrales A, Calvo Rio V, et al. Subclinical atherosclerotic disease in ankylosing spondylitis and non-radiographic axial spondyloarthritis. A multicenter study on 806 patients. Semin Arthritis Rheum. 2021;51(2):395-403.
XII. González-Juanatey C, Vázquez-Rodríguez TR, Miranda-Filloy JA, Dierssen T, Vaqueiro I, Blanco R, et al. The high prevalence of subclinical atherosclerosis in patients with ankylosing spondylitis without clinically evident cardiovascular disease. Medicine (Baltimore). 2009;88(6):358-65.
XIII. Kim JH, Choi IA. Cardiovascular morbidity and mortality in patients with spondyloarthritis: A meta-analysis. Int J Rheum Dis. 2021;24(4):477-86.
XIV. D'Agostino RB, Sr., Grundy S, Sullivan LM, Wilson P. Validation of the Framingham coronary heart disease prediction scores: results of a multiple ethnic groups investigation. JAMA. 2001;286(2):180-7.
XV. Cazenave T OM, Citera G, Schneeberger EE, Rosemffet MG. Subclinical atheromatosis and estimation of cardiovascular risk in patients with axial spondyloarthritis [abstract]. Arthritis Rheumatol. 2018;70(suppl 9).
XVI. Lautermann D, Braun J. Ankylosing spondylitis: cardiac manifestations. Clin Exp Rheumatol. 2002;20(6 Suppl 28):S11-5.
XVII. Elewaut D, Matucci-Cerinic M. Treatment of ankylosing spondylitis and extra-articular manifestations in everyday rheumatology practice. Rheumatology (Oxford). 2009;48(9):1029-35.
XVIII. Momeni M, Taylor N, Tehrani M. Cardiopulmonary manifestations of ankylosing spondylitis. Int J Rheumatol. 2011;2011:728471.
XIX. Zhao SS, Radner H, Siebert S, Duffield SJ, Thong D, Hughes DM, et al. Comorbidity burden in axial spondyloarthritis: a cluster analysis. Rheumatology (Oxford). 2019;58(10):1746-54.
XX. Peters MJ, van der Horst-Bruinsma IE, Dijkmans BA, Nurmohamed MT. Cardiovascular risk profile of patients with spondylarthropathies, particularly ankylosing spondylitis and psoriatic arthritis. Semin Arthritis Rheum. 2004;34(3):585-92.
XXI. Gherghe AM, Dougados M, Combe B, Landewé R, Mihai C, Berenbaum F, et al. Cardiovascular and selected comorbidities in early arthritis and early spondyloarthritis, a comparative study: results from the ESPOIR and DESIR cohorts. RMD Open. 2015;1(1):e000128.
XXII. Johnson AG, Nguyen TV, Day RO. Do nonsteroidal anti-inflammatory drugs affect blood pressure? A meta-analysis. Ann Intern Med. 1994;121(4):289-300.
XXIII. Liew JW, Ward MM, Reveille JD, Weisman M, Brown MA, Lee M, et al. Nonsteroidal antiinflammatory drug use and association with incident hypertension in ankylosing spondylitis. Arthritis Care Res (Hoboken). 2020;72(11):1645-52.
XXIV. Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, et al. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA. 2002;288(21):2709-16.
XXV. Malesci D, Niglio A, Mennillo GA, Buono R, Valentini G, La Montagna G. High prevalence of metabolic syndrome in patients with ankylosing spondylitis. Clin Rheumatol. 2007;26(5):710-4.
XXVI. Liu M, Huang Y, Huang Z, Huang Q, Guo X, Wang Y, et al. Prevalence of metabolic syndrome and its associated factors in Chinese patients with ankylosing spondylitis. Diabetes Metab Syndr Obes. 2019;12:477-84.
XXVII. Maia DG, Augusto KL, Bezerra MC, Rodrigues CEM. Metabolic syndrome in patients with ankylosing spondylitis receiving anti-TNFα therapy: association with predictors of cardiovascular risk. Clin Rheumatol. 2017;36(10):2371-6.
XXVIII. Maruotti N, d'Onofrio F, Cantatore FP. Metabolic syndrome and chronic arthritis: effects of anti-TNF-α therapy. Clin Exp Med. 2015;15(4):433-8.
XXIX. Maas F, Arends S, van der Veer E, Wink F, Efde M, Bootsma H, et al. Obesity Is common in axial spondyloarthritis and is associated with poor clinical outcome. J Rheumatol. 2016;43(2):383-7.
XXX. Choy E, Ganeshalingam K, Semb AG, Szekanecz Z, Nurmohamed M. Cardiovascular risk in rheumatoid arthritis: recent advances in the understanding of the pivotal role of inflammation, risk predictors and the impact of treatment. Rheumatology (Oxford). 2014;53(12):2143-54.
XXXI. Rössner S. Further studies on serum lipoproteins in connective tissue diseases. Atherosclerosis. 1978;31(1):93-9.
XXXII. Joven J, Rubiés-Prat J, Ras MR, de la Figuera M, Lience E, Masdeu S. High density lipoprotein cholesterol subfractions and apoprotein A-I in patients with rheumatoid arthritis and ankylosing spondylitis. Arthritis Rheum. 1984;27(10):1199-200.
XXXIII. Azevedo VF, Pecoits-Filho R. Atherosclerosis and endothelial dysfunction in patients with ankylosing spondylitis. Rheumatol Int. 2010;30(11):1411-6.
XXXIV. Papagoras C, Markatseli TE, Saougou I, Alamanos Y, Zikou AK, Voulgari PV, et al. Cardiovascular risk profile in patients with spondyloarthritis. Joint Bone Spine. 2014;81(1):57-63.
XXXV. Semb AG, Kvien TK, DeMicco DA, Fayyad R, Wun CC, LaRosa J, et al. Prediction of cardiovascular events in patients with ankylosing spondylitis and psoriatic arthritis: role of lipoproteins in a high-risk population. J Rheumatol. 2012;39(7):1433-40.
XXXVI. Cardiología SAd. Riesgo cardiovascular en las enfermedades inflamatorias crónicas. Rev Argent Cardiol. 2019;87 (Sup 2):1-45.
XXXVII. Zhao SS, Jones GT, Hughes DM, Moots RJ, Goodson NJ. Depression and anxiety symptoms at TNF inhibitor initiation are associated with impaired treatment response in axial spondyloarthritis. Rheumatology (Oxford). 2021;60(12):5734-42.
XXXVIII. Zhao SS, Jones GT, Macfarlane GJ, Hughes DM, Moots RJ, Goodson NJ. Comorbidity and response to TNF inhibitors in axial spondyloarthritis: longitudinal analysis of the BSRBR-AS. Rheumatology (Oxford). 2021;60(9):4158-65.
XXXIX. Kilic G, Kilic E, Ozgocmen S. Relationship between psychiatric status, self-reported outcome measures, and clinical parameters in axial spondyloarthritis. Medicine (Baltimore). 2014;93(29):e337.
XL. Zhao S, Thong D, Miller N, Duffield SJ, Hughes DM, Chadwick L, et al. The prevalence of depression in axial spondyloarthritis and its association with disease activity: a systematic review and meta-analysis. Arthritis Res Ther. 2018;20(1):140.
XLI. Beck AT WC, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561-71.
XLII. Siddaway AP, Wood AM, Taylor PJ. The Center for Epidemiologic Studies-Depression (CES-D) scale measures a continuum from well-being to depression: Testing two key predictions of positive clinical psychology. J Affect Disord. 2017;213:180-6.
XLIII. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-13.
XLIV. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361-70.
XLV. Spielberger C GR LR, editor. Cuestionario de Ansiedad Estado-Rasgo, STAI. 1982;9th ed. Madrid: TEA Ediciones.
XLVI. Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092-7.
XLVII. Dowlati Y, Herrmann N, Swardfager W, Liu H, Sham L, Reim EK, et al. A meta-analysis of cytokines in major depression. Biol Psychiatry. 2010;67(5):446-57.
XLVIII. Miller AH, Raison CL. The role of inflammation in depression: from evolutionary imperative to modern treatment target. Nat Rev Immunol. 2016;16(1):22-34.
XLIX. Webers C, Vanhoof L, Leue C, Boonen A, Köhler S. Depression in ankylosing spondylitis and the role of disease-related and contextual factors: a cross-sectional study. Arthritis Res Ther. 2019;21(1):215.
L. Park JS, Jang HD, Hong JY, Park YS, Han K, Suh SW, et al. Impact of ankylosing spondylitis on depression: a nationwide cohort study. Sci Rep. 2019;9(1):6736.
LI. Zhang L, Wu Y, Liu S, Zhu W. Prevalence of Depression in Ankylosing Spondylitis: A Systematic Review and Meta-Analysis. Psychiatry Investig. 2019;16(8):565-74.
LII. Sundquist K, Li X, Hemminki K, Sundquist J. Subsequent risk of hospitalization for neuropsychiatric disorders in patients with rheumatic diseases: a nationwide study from Sweden. Arch Gen Psychiatry. 2008;65(5):501-7.
LIII. Giorgis PC, Schneeberger E, Carrizo Abarza V, Macias Oviedo, et al. Prevalencia de depresión y ansiedad en pacientes con espondiloartitis axial Revista Argentina de Reumatología. Rev Argent Reumatol 2019;(Sup Congreso).
LIV. Chan CYY, Tsang HHL, Lau CS, Chung HY. Prevalence of depressive and anxiety disorders and validation of the Hospital Anxiety and Depression Scale as a screening tool in axial spondyloarthritis patients. Int J Rheum Dis. 2017;20(3):317-25.
LV. Meesters JJ, Petersson IF, Bergman S, Haglund E, Jacobsson LT, Bremander A. Sociodemographic and disease-related factors are associated with patient-reported anxiety and depression in spondyloarthritis patients in the Swedish SpAScania cohort. Clin Rheumatol. 2014;33(11):1649-56.
LVI. Reddy KN, Sabu N, Pandey N, Raut A, Joag K, Patil P. Anxiety and depression among patients with axial spondyloarthritis. Eur J Rheumatol. 2022;9(1):8-13.
LVII. Shen CC, Hu LY, Yang AC, Kuo BI, Chiang YY, Tsai SJ. Risk of psychiatric disorders following ankylosing spondylitis: a nationwide population-based retrospective cohort study. J Rheumatol. 2016;43(3):625-31.
LVIII. Parkinson JT, Foley É M, Jadon DR, Khandaker GM. Depression in patients with spondyloarthritis: prevalence, incidence, risk factors, mechanisms and management. Ther Adv Musculoskelet Dis. 2020;12:1759720X20970028.
LIX. Mercer LK, Davies R, Galloway JB, Low A, Lunt M, Dixon WG, et al. Risk of cancer in patients receiving non-biologic disease-modifying therapy for rheumatoid arthritis compared with the UK general population. Rheumatology (Oxford). 2013;52(1):91-8.
LX. Ao Y, Wen Y, Li Y, Peng H, Wu X, Wang Z, et al. Ankylosing spondylitis and the risk of lung cancer: a meta-analysis and mendelian randomization. Front Genet. 2022;13:861984.
LXI. Sun LM, Muo CH, Liang JA, Chang SN, Sung FC, Kao CH. Increased risk of cancer for patients with ankylosing spondylitis: a nationwide population-based retrospective cohort study. Scand J Rheumatol. 2014;43(4):301-6.
LXII. Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow? Lancet. 2001;357(9255):539-45.
LXIII. Chai EZ, Siveen KS, Shanmugam MK, Arfuso F, Sethi G. Analysis of the intricate relationship between chronic inflammation and cancer. Biochem J. 2015;468(1):1-15.
LXIV. Carmona L, Abasolo L, Descalzo MA, Perez-Zafrilla B, Sellas A, de Abajo F, et al. Cancer in patients with rheumatic diseases exposed to TNF antagonists. Semin Arthritis Rheum. 2011;41(1):71-80.
LXV. Atzeni F, Carletto A, Foti R, Sebastiani M, Panetta V, Salaffi F, et al. Incidence of cancer in patients with spondyloarthritis treated with anti-TNF drugs. Joint Bone Spine. 2018;85(4):455-9.
LXVI. Hellgren K, Dreyer L, Arkema EV, Glintborg B, Jacobsson LT, Kristensen LE, et al. Cancer risk in patients with spondyloarthritis treated with TNF inhibitors: a collaborative study from the ARTIS and DANBIO registers. Ann Rheum Dis. 2017;76(1):105-11.
LXVII. Kwan YH, Lim KK, Fong W, Goh H, Ng L, Haaland B, et al. Risk of malignancies in patients with spondyloarthritis treated with biologics compared with those treated with non-biologics: a systematic review and meta-analysis. Ther Adv Musculoskelet Dis. 2020;12:1759720X20925696.
LXVIII. Deng C, Li W, Fei Y, Li Y, Zhang F. Risk of malignancy in ankylosing spondylitis: a systematic review and meta-analysis. Sci Rep. 2016;6:32063.
LXIX. Walsh JA, Song X, Kim G, Park Y. Evaluation of the comorbidity burden in patients with ankylosing spondylitis using a large US administrative claims data set. Clin Rheumatol. 2018;37(7):1869-78.
LXX. Burmester GR, Panaccione R, Gordon KB, McIlraith MJ, Lacerda AP. Adalimumab: long-term safety in 23 458 patients from global clinical trials in rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis, psoriatic arthritis, psoriasis and Crohn's disease. Ann Rheum Dis. 2013;72(4):517-24.
LXXI. Chang CC, Chang CW, Nguyen PA, Chang TH, Shih YL, Chang WY, et al. Ankylosing spondylitis and the risk of cancer. Oncol Lett. 2017;14(2):1315-22.
LXXII. Feltelius N, Ekbom A, Blomqvist P. Cancer incidence among patients with ankylosing spondylitis in Sweden 1965-95: a population based cohort study. Ann Rheum Dis. 2003;62(12):1185-8.
LXXIII. Dreyer L, Mellemkjær L, Andersen AR, Bennett P, Poulsen UE, Juulsgaard Ellingsen T, et al. Incidences of overall and site specific cancers in TNFα inhibitor treated patients with rheumatoid arthritis and other arthritides. A follow-up study from the DANBIO Registry. Ann Rheum Dis. 2013;72(1):79-82.
LXXIV. Bittar M, Merjanah S, Alkilany R, Magrey M. Malignancy in ankylosing spondylitis: a cross-sectional analysis of a large population database. BMC Rheumatol. 2022;6(1):44.
LXXV. Darby SC, Doll R, Gill SK, Smith PG. Long term mortality after a single treatment course with X-rays in patients treated for ankylosing spondylitis. Br J Cancer. 1987;55(2):179-90.
LXXVI. Brown LM, Gridley G, Check D, Landgren O. Risk of multiple myeloma and monoclonal gammopathy of undetermined significance among white and black male United States veterans with prior autoimmune, infectious, inflammatory, and allergic disorders. Blood. 2008;111(7):3388-94.
LXXVII. Lindqvist EK, Goldin LR, Landgren O, Blimark C, Mellqvist UH, Turesson I, et al. Personal and family history of immune-related conditions increase the risk of plasma cell disorders: a population-based study. Blood. 2011;118(24):6284-91.
LXXVIII. Hemminki K, Liu X, Försti A, Ji J, Sundquist J, Sundquist K. Effect of autoimmune diseases on incidence and survival in subsequent multiple myeloma. J Hematol Oncol. 2012;5:59.
LXXIX. Lee E HK, Song Y, Lee E. Cancer risk in patients with ankylosing spondylitis: a nationwide population-based dynamic cohort study from Korea [abstract]. Arthritis Rheumatol. 2019;71 (suppl 10). Disponoble en: https://acrabstracts.org/abstract/cancer-risk-in-patients-with-ankylosing-spondylitis-a-nationwide-population-based-dynamic-cohort-study-from-korea/.
LXXX. Alehashemi S WM. Cancer risk in ankylosing spondylitis in United States medicare beneficiaries: detection of a chronic non steroidal anti-inflammatory drug use signature [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). Disponible en: https://acrabstracts.org/abstract/cancer-risk-in-ankylosing-spondylitis-in-united-states-medicare-beneficiaries-detection-of-a-chronic-non-steroidal-anti-inflammatory-drug-use-signature/. Accessed September 18, 2023.
LXXXI. Fagerli KM, Kearsley-Fleet L, Mercer LK, Watson K, Packham J, Symmons DPM, et al. Malignancy and mortality rates in patients with severe psoriatic arthritis requiring tumour-necrosis factor alpha inhibition: results from the British Society for Rheumatology Biologics Register. Rheumatology (Oxford). 2019;58(1):80-5.
LXXXII. Saliba L, Moulis G, Abou Taam M, Rousseau V, Chebane L, Petitpain N, et al. Tumor necrosis factor inhibitors added to nonbiological immunosuppressants vs. nonbiological immunosuppressants alone: a different signal of cancer risk according to the condition. A disproportionality analysis in a nationwide pharmacovigilance database. Fundam Clin Pharmacol. 2016;30(2):162-71.
LXXXIII. Haynes K, Beukelman T, Curtis JR, Newcomb C, Herrinton LJ, Graham DJ, et al. Tumor necrosis factor α inhibitor therapy and cancer risk in chronic immune-mediated diseases. Arthritis Rheum. 2013;65(1):48-58.
LXXXIV. van der Heijde D, Zack D, Wajdula J, Sridharan S, Koenig AS. Rates of serious infections, opportunistic infections, inflammatory bowel disease, and malignancies in subjects receiving etanercept vs. controls from clinical trials in ankylosing spondylitis: a pooled analysis. Scand J Rheumatol. 2014;43(1):49-53.
LXXXV. Westhovens I, Lories RJ, Westhovens R, Verschueren P, de Vlam K. Anti-TNF therapy and malignancy in spondyloarthritis in the Leuven spondyloarthritis biologics cohort (BIOSPAR). Clin Exp Rheumatol. 2014;32(1):71-6.
LXXXVI. Kim HW, Kim EH, Lee M, Jung I, Ahn SS. Risk of cancer, tuberculosis and serious infections in patients with ankylosing spondylitis, psoriatic arthritis and psoriasis treated with IL-17 and TNF-α inhibitors: a nationwide nested case-control analysis. Clin Exp Rheumatol. 2023;41(7):1491-9.
LXXXVII. Russell MD, Stovin C, Alveyn E, Adeyemi O, Chan CKD, Patel V, et al. JAK inhibitors and the risk of malignancy: a meta-analysis across disease indications. Ann Rheum Dis. 2023;82(8):1059-67.
LXXXVIII. Pundole X, Zamora NV, Siddhanamatha H, Lin H, Tayar J, Hong LC, et al. Utilization of biologic disease-modifying anti-rheumatic drugs in patients with rheumatoid arthritis and cancer. Clin Rheumatol. 2020;39(3):787-94.
LXXXIX. Xie W, Xiao S, Huang Y, Sun X, Gao D, Ji L, et al. A meta-analysis of biologic therapies on risk of new or recurrent cancer in patients with rheumatoid arthritis and a prior malignancy. Rheumatology (Oxford). 2020;59(5):930-9.
XC. Micic D, Komaki Y, Alavanja A, Rubin DT, Sakuraba A. Risk of cancer recurrence among individuals exposed to antitumor necrosis factor therapy: a systematic review and meta-analysis of observational studies. J Clin Gastroenterol. 2019;53(1):e1-e11.
XCI. Taurog JD, Chhabra A, Colbert RA. Ankylosing spondylitis and axial spondyloarthritis. N Engl J Med. 2016;374(26):2563-74.
XCII. Montala N, Juanola X, Collantes E, Muñoz-Gomariz E, Gonzalez C, Gratacos J, et al. Prevalence of vertebral fractures by semiautomated morphometry in patients with ankylosing spondylitis. J Rheumatol. 2011;38(5):893-7.
XCIII. Jun JB, Joo KB, Her MY, Kim TH, Bae SC, Yoo DH, et al. Femoral bone mineral density is associated with vertebral fractures in patients with ankylosing spondylitis: a cross-sectional study. J Rheumatol. 2006;33(8):1637-41.
XCIV. NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA. 2001;285(6):785-95.
XCV. Cummings SR, Bates D, Black DM. Clinical use of bone densitometry: scientific review. JAMA. 2002;288(15):1889-97.
XCVI. Kanis JA. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporos Int. 1994;4(6):368-81.
XCVII. Chaudhary SB, Hullinger H, Vives MJ. Management of acute spinal fractures in ankylosing spondylitis. ISRN Rheumatol. 2011;2011:150484.
XCVIII. Cooper C, Carbone L, Michet CJ, Atkinson EJ, O'Fallon WM, Melton LJ, 3rd. Fracture risk in patients with ankylosing spondylitis: a population based study. J Rheumatol. 1994;21(10):1877-82.
XCIX. Robinson Y, Sandén B, Olerud C. Increased occurrence of spinal fractures related to ankylosing spondylitis: a prospective 22-year cohort study in 17,764 patients from a national registry in Sweden. Patient Saf Surg. 2013;7(1):2.
C. Vosse D, de Vlam K. Osteoporosis in rheumatoid arthritis and ankylosing spondylitis. Clin Exp Rheumatol. 2009;27(4 Suppl 55):S62-7.
CI. Ghozlani I, Ghazi M, Nouijai A, Mounach A, Rezqi A, Achemlal L, et al. Prevalence and risk factors of osteoporosis and vertebral fractures in patients with ankylosing spondylitis. Bone. 2009;44(5):772-6.
CII. Klingberg E, Geijer M, Göthlin J, Mellström D, Lorentzon M, Hilme E, et al. Vertebral fractures in ankylosing spondylitis are associated with lower bone mineral density in both central and peripheral skeleton. J Rheumatol. 2012;39(10):1987-95.
CIII. van der Weijden MA, Claushuis TA, Nazari T, Lems WF, Dijkmans BA, van der Horst-Bruinsma IE. High prevalence of low bone mineral density in patients within 10 years of onset of ankylosing spondylitis: a systematic review. Clin Rheumatol. 2012;31(11):1529-35.
CIV. Ramírez J, Nieto-González JC, Curbelo Rodríguez R, Castaneda S, Carmona L. Prevalence and risk factors for osteoporosis and fractures in axial spondyloarthritis: A systematic review and meta-analysis. Semin Arthritis Rheum. 2018;48(1):44-52.
CV. Klingberg E, Lorentzon M, Mellström D, Geijer M, Göthlin J, Hilme E, et al. Osteoporosis in ankylosing spondylitis: prevalence, risk factors and methods of assessment. Arthritis Res Ther. 2012;14(3):R108.
CVI. Geusens P, Vosse D, van der Linden S. Osteoporosis and vertebral fractures in ankylosing spondylitis. Curr Opin Rheumatol. 2007;19(4):335-9.
CVII. Wang DM, Zeng QY, Chen SB, Gong Y, Hou ZD, Xiao ZY. Prevalence and risk factors of osteoporosis in patients with ankylosing spondylitis: a 5-year follow-up study of 504 cases. Clin Exp Rheumatol. 2015;33(4):465-70.
CVIII. Kim JW, Park S, Jung JY, Kim HA, Kwon SR, Choi ST, et al. Prevalence and factors of osteoporosis and high risk of osteoporotic fracture in patients with ankylosing spondylitis: a multicenter comparative study of bone mineral density and the fracture risk assessment Tool. J Clin Med. 2022;11(10).
CIX. Feldtkeller E, Vosse D, Geusens P, van der Linden S. Prevalence and annual incidence of vertebral fractures in patients with ankylosing spondylitis. Rheumatol Int. 2006;26(3):234-9.
CX. Vosse D, van der Heijde D, Landewé R, Geusens P, Mielants H, Dougados M, et al. Determinants of hyperkyphosis in patients with ankylosing spondylitis. Ann Rheum Dis. 2006;65(6):770-4.
CXI. Sinigaglia L, Varenna M, Girasole G, Bianchi G. Epidemiology of osteoporosis in rheumatic diseases. Rheum Dis Clin North Am. 2006;32(4):631-58.
CXII. Chavassieux P, Seeman E, Delmas PD. Insights into material and structural basis of bone fragility from diseases associated with fractures: how determinants of the biomechanical properties of bone are compromised by disease. Endocr Rev. 2007;28(2):151-64.
CXIII. Lange U, Kluge A, Strunk J, Teichmann J, Bachmann G. Ankylosing spondylitis and bone mineral density. What is the ideal tool for measurement? Rheumatol Int. 2005;26(2):115-20.
CXIV. Arends S, Spoorenberg A, Bruyn GA, Houtman PM, Leijsma MK, Kallenberg CG, et al. The relation between bone mineral density, bone turnover markers, and vitamin D status in ankylosing spondylitis patients with active disease: a cross-sectional analysis. Osteoporos Int. 2011;22(5):1431-9.
CXV. Bouxsein ML, Melton LJ, 3rd, Riggs BL, Muller J, Atkinson EJ, Oberg AL, et al. Age- and sex-specific differences in the factor of risk for vertebral fracture: a population-based study using QCT. J Bone Miner Res. 2006;21(9):1475-82.
CXVI. Trout AT, Kallmes DF, Layton KF, Thielen KR, Hentz JG. Vertebral endplate fractures: an indicator of the abnormal forces generated in the spine after vertebroplasty. J Bone Miner Res. 2006;21(11):1797-802.
CXVII. Karberg K, Zochling J, Sieper J, Felsenberg D, Braun J. Bone loss is detected more frequently in patients with ankylosing spondylitis with syndesmophytes. J Rheumatol. 2005;32(7):1290-8.
CXVIII. Geusens P, Vosse D, van der Heijde D, Vanhoof J, van Tubergen A, Raus J, et al. High prevalence of thoracic vertebral deformities and discal wedging in ankylosing spondylitis patients with hyperkyphosis. J Rheumatol. 2001;28(8):1856-61.
CXIX. Magrey MN, Lewis S, Asim Khan M. Utility of DXA scanning and risk factors for osteoporosis in ankylosing spondylitis. A prospective study. Semin Arthritis Rheum. 2016;46(1):88-94.
CXX. Schett G, Rudwaleit M. Can we stop progression of ankylosing spondylitis? Best Pract Res Clin Rheumatol. 2010;24(3):363-71.
CXXI. Betancur GV ZN, Schneeberger EE, Orozco MC, Sommerfleck F, Lizarraga A, Citera G. Influencia del daño radiológico en el resultado de la densitometría ósea de la columna lumbar en pacientes con espondiloartritis axial. ¿hay otra región por densitometría que refleje mejor la densidad mineral ósea del hueso trabecular? Rev Argen Reumatol. 2015;26(4).
CXXII. Bessant R, Harris C, Keat A. Audit of the diagnosis, assessment, and treatment of osteoporosis in patients with ankylosing spondylitis. J Rheumatol. 2003;30(4):779-82.
CXXIII. Davey-Ranasinghe N, Deodhar A. Osteoporosis and vertebral fractures in ankylosing spondylitis. Curr Opin Rheumatol. 2013;25(4):509-16.
CXXIV. Mermerci Başkan B, Pekin Doğan Y, Sivas F, Bodur H, Ozoran K. The relation between osteoporosis and vitamin D levels and disease activity in ankylosing spondylitis. Rheumatol Int. 2010;30(3):375-81.
Derechos de autor 2024 a nombre de los autores. Derechos de reproducción: Sociedad Argentina de Reumatología
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