Prevalence and Factors Associated with Vertebral Fractures in Psoriatic Arthritis

Osteoporosis and fractures are common comorbidities in inflammatory arthritis. Osteoporosis prevalence in psoriatic arthritis (PsA) is not known. I aimed to synthesize current evidence by conducting a systematic review of the literature and determine the prevalence and factors associated with radiographic vertebral fractures in PsA patients. A systematic review of literature, conforming to PRISMA guidelines, synthesized inconsistent and non-conclusive evidence pertaining to presence of osteoporosis and fractures in PsA. Vertebral fractures were identified by quantitative morphometric assessment on lateral spinal radiographs of lumbar (L) and thoracic (T) spine (T6-L4) after demonstrating a high inter- and intra-assessor reliability. Covariates including demographic features, measures of disease activity, body mass index and pharmacologic treatment were investigated as associated factors. We found a low prevalence of vertebral fractures in PsA (5.3%). Age (OR 1.08, 95% CI [1.04, 1.12], PM.Sc