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Diagnóstico de Osteoporose em doentes com Artrite Psoriática - análise numa Unidade de Reumatologia da Beira Interior
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Abstract(s)
Introdução: A artrite psoriática (APso) é uma doença inflamatória crónica que afeta as
articulações e a pele, ocorrendo em indivíduos com psoríase. A osteoporose (OP), por sua
vez, caracteriza-se pela diminuição da densidade mineral óssea, aumentando o risco de
fraturas. Estudos recentes sugerem que pacientes com APso possuem um risco aumentado
de desenvolver OP devido à inflamação crónica e ao uso prolongado de corticosteroides.
Objetivo: O estudo tem como objetivo analisar a prevalência de osteoporose em pacientes
com artrite psoriática acompanhados numa unidade de Reumatologia da Beira Interior.
Métodos: Trata-se de um estudo observacional, transversal, retrospetivo e monocêntrico,
realizado com 32 pacientes diagnosticados com APso e acompanhados na consulta de
Reumatologia da Unidade Local de Saúde de Castelo Branco (ULSCB). Foram analisadas
variáveis como idade, sexo, comorbilidades, consumo tabágico, terapêutica utilizada,
parâmetros laboratoriais e exames de densitometria óssea (DEXA). A análise estatística foi
realizada através de estatística descritiva, com recurso à plataforma Microsoft Excel.
Discussão: Os resultados demonstraram uma baixa prevalência de OP (6,25%) e
osteopenia (6,25%) na amostra, valores inferiores aos descritos na literatura. A baixa taxa
de realização de DEXA (31,25%) sugere um possível subdiagnóstico da doença. O uso de
corticosteroides foi elevado (65,63%), o que pode impactar negativamente a densidade
óssea. Além disso, a terapêutica biológica, utilizada por 65,63% dos doentes, pode ter efeitos
protetores sobre a massa óssea, necessitando de estudos mais aprofundados. A ausência de
fraturas identificadas contrasta com estudos que indicam maior risco de fraturas na APso,
sugerindo a necessidade de melhor rastreio imagiológico.
Conclusão: A OP pode estar subdiagnosticada nos doentes com APso, reforçando a
necessidade de rastreio precoce com DEXA. A elevada taxa de utilização de corticosteroides
pode ter impacto negativo na densidade óssea, enquanto o uso de terapêutica biológica pode
ser um fator protetor. Estudos futuros devem explorar a influência da atividade da doença
e da terapêutica na remodelação óssea, permitindo a implementação de estratégias
preventivas mais eficazes.
Introduction: Psoriatic arthritis (PsA) is a chronic inflammatory disease that affects the joints and skin, occurring in individuals with psoriasis. Osteoporosis (OP), on the other hand, is characterized by decreased bone mineral density, increasing the risk of fractures. Recent studies suggest that PsA patients have an increased risk of developing OP due to chronic inflammation and prolonged corticosteroid use. Objective: This study aims to analyze the prevalence of osteoporosis in patients with psoriatic arthritis followed in a Rheumatology unit in Beira Interior. Methods: This is an observational, cross-sectional, retrospective, and monocentric study conducted with 32 patients diagnosed with PsA and followed in the Rheumatology outpatient clinic of the Local Health Unit of Castelo Branco (ULSCB). Variables such as age, sex, comorbidities, smoking habits, prescribed treatments, laboratory parameters, and dual-energy X-ray absorptiometry (DEXA) results were analyzed. Statistical analysis was performed using descriptive statistics with Microsoft Excel. Discussion: The results showed a low prevalence of OP (6.25%) and osteopenia (6.25%) in the sample, values lower than those reported in the literature. The low rate of DEXA screening (31.25%) suggests a possible underdiagnosis of the disease. Corticosteroid use was high (65.63%), which may negatively impact bone density. Additionally, biological therapy, used by 65.63% of patients, may have protective effects on bone mass, requiring further studies. The absence of identified fractures contrasts with studies indicating a higher risk of fractures in PsA, highlighting the need for improved imaging screening. Conclusion: OP may be underdiagnosed in patients with PsA, reinforcing the need for early screening with DEXA. The high rate of corticosteroid use may negatively impact bone density, while biological therapy may act as a protective factor. Future studies should explore the influence of disease activity and therapy on bone remodeling, allowing for the implementation of more effective preventive strategies.
Introduction: Psoriatic arthritis (PsA) is a chronic inflammatory disease that affects the joints and skin, occurring in individuals with psoriasis. Osteoporosis (OP), on the other hand, is characterized by decreased bone mineral density, increasing the risk of fractures. Recent studies suggest that PsA patients have an increased risk of developing OP due to chronic inflammation and prolonged corticosteroid use. Objective: This study aims to analyze the prevalence of osteoporosis in patients with psoriatic arthritis followed in a Rheumatology unit in Beira Interior. Methods: This is an observational, cross-sectional, retrospective, and monocentric study conducted with 32 patients diagnosed with PsA and followed in the Rheumatology outpatient clinic of the Local Health Unit of Castelo Branco (ULSCB). Variables such as age, sex, comorbidities, smoking habits, prescribed treatments, laboratory parameters, and dual-energy X-ray absorptiometry (DEXA) results were analyzed. Statistical analysis was performed using descriptive statistics with Microsoft Excel. Discussion: The results showed a low prevalence of OP (6.25%) and osteopenia (6.25%) in the sample, values lower than those reported in the literature. The low rate of DEXA screening (31.25%) suggests a possible underdiagnosis of the disease. Corticosteroid use was high (65.63%), which may negatively impact bone density. Additionally, biological therapy, used by 65.63% of patients, may have protective effects on bone mass, requiring further studies. The absence of identified fractures contrasts with studies indicating a higher risk of fractures in PsA, highlighting the need for improved imaging screening. Conclusion: OP may be underdiagnosed in patients with PsA, reinforcing the need for early screening with DEXA. The high rate of corticosteroid use may negatively impact bone density, while biological therapy may act as a protective factor. Future studies should explore the influence of disease activity and therapy on bone remodeling, allowing for the implementation of more effective preventive strategies.
Description
Keywords
Artrite Psoriática Corticosteroides Densidade Mineral Óssea Inflamação Crónica Osteoporose Terapêutica Biológica