OSTEOPOROSIS IN PATIENTS WITH ANKYLOSING SPONDYLITIS

Abstract

Osteoporosis (OP) is a frequent complication of ankylosing spondylitis (AS). The risk factors of OP in AS are permanent inflammatory activity, disease duration, patient immobilization, and vitamin D deficiency. Proinflammatory cytokines that favor osteoclustogenesis play a fundamental role in the pathogenesis of bone resorption in AS. The problem of OP in AS cannot be viewed in isolation from bone metabolism as a whole and from the processes of pathological osteogenesis. Ankylosis-induced spine rigidity concurrent with vertebral body OP increases the risk of spinal fractures in patients with AS. Osteogenesis in AS leads to overestimation of the results obtained by dual-energy X-ray absorptiometry (DXA) when determining lumbar bone mineral density (BMD). Lateral DXA scanning of the spine is a more sensitive technique for BMD estimation. The early use of tumor necrosis factor-α inhibitors is able to prevent OP in patients with AS.