THU0344 Osteoporosis and Vertebral Fractures in Patients with Systemic Lupus Erythematosus: A Systematic Review and Meta-Analysis

BackgroundObservational studies have indicated a high but heterogeneous prevalence of low bone mineral density (BMD) and vertebral fractures (VR) in patients with systemic lupus erythematosus (SLE).ObjectivesTo evaluate the relationship between SLE and BMD, osteoporosis and the risk of vertebral fracture.MethodsA systematic review and meta-regression analyses were carried out according to the Preferred Reporting Items for Systematic Meta-Analyses (PRISMA) guidelines. Articles were identified from electronic databases (PubMed, Embase, VHL, SciELO and the Cochrane Library). The search was conducted using MesH terms, Boolean operators and keywords, which included “systemic lupus erythematosus”, “osteoporosis”, “bone mineral density”, and “vertebral fractures”. Prospective longitudinal and cross-sectional studies were considered for review without language restrictions. Articles were screened for suitability. Those selected were evaluated by two investigators, who extracted information on study characteristics, outcomes of interest, and risk of bias, and summarized the strength of evidence. Data was extracted when studies met inclusion criteria and were of sufficient quality. BMD, reported as the mean ± standard deviation evaluated by dual-energy X-ray absorptiometry (DXA), was analyzed including information on SLE cases and controls, treatment, menopausal status and fractures by meta-regression analysis adjusted by anatomical region. Data were analyzed using the Metafor package in R (3.0.2 version).ResultsIn total 49 articles were identified and analyzed (12, 593 SLE cases/six anatomical regions and 14,235 controls/six anatomical regions). SLE women, but not SLE men, had a lower BMD than healthy controls (p