Experts who treat lupus patients know that having this autoimmune disease increases the risk of osteoporosis — thinning bones that may lead to debilitating fractures. While the common belief has been that some of the drugs used to treat lupus are to blame, a new study suggests that there’s far more to it.
Many lupus patients take glucocorticoid medications like prednisone to help manage flares, at least from time to time, and osteoporosis is a well-known side effect of these drugs. Yet the researchers who conducted this study specifically adjusted for the impact of glucocorticoids.
According to the study, which was published in the journal Arthritis Care & Research, people with lupus are 62 percent more likely than those without it to experience a hip fracture “after adjusting for baseline risk factors including and time-varying variables, including glucocorticoid use and health resource utilization.”
To conduct the study, Canadian researchers analyzed data on more than 5,000 patients with lupus that spanned nearly 11 years and compared it to data on more than 25,000 control subjects who did not have lupus.
The authors said that bone loss in lupus patients is likely multifactorial: While glucocorticoid use surely plays a role, high levels of inflammation might also be responsible for increasing the rate at which old bone is broken down and slowing the rate at which new bone cells are formed.
They concluded that this research “expands on the findings of previous studies and has important implications for the prevention, screening, and treatment of osteoporosis that may lead to hip fractures. Further studies should clarify the impact of inflammation, glucocorticoid dosage, and duration of use on the risk of hip fractures among [lupus] patients.”
If you have lupus, the National Institutes of Health emphasize the importance of getting adequate calcium and vitamin D, engaging in weight-bearing exercise, and asking your doctor when you should have your bone density tested.
Li L, et al. The Impact of Systemic Lupus Erythematosus on the Risk of Newly Diagnosed Hip Fracture. A General Population‐Based Study. Arthritis Care & Research. November 2019. doi: https://doi.org/10.1002/acr.24112.
Treating Lupus with Steroids. Johns Hopkins Lupus Center. https://www.hopkinslupus.org/lupus-treatment/lupus-medications/steroids.
What People With Lupus Need To Know About Osteoporosis. National Institutes of Health Osteoporosis and Related Bone Diseases National Resource Center. https://www.bones.nih.gov/health-info/bone/osteoporosis/conditions-behaviors/osteoporosis-lupus#b.