Epidemiology and factors associated with osteoporosis, falls and fractures in patients with chronic inflammatory rheumatic disease: a scoping review.

objectivesTo describe the available literature on the epidemiology and factors associated with osteoporosis, falls and fractures in four chronic inflammatory rheumatic diseases (CIRD): rheumatoid arthritis (RA); psoriatic arthritis (PsA); ankylosing spondylitis (AS); and systemic lupus erythematosus (SLE).

designScoping review, using the Joanna Briggs Institute framework. DATA SOURCES: MEDLINE, Embase and CINAHL from January 2000 to December 2023. ELIGIBILITY CRITERIA: Observational studies reporting on the epidemiology and/or associated factors for osteoporosis, falls and fractures in RA, PsA, AS or SLE. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers used a standard data extraction form including report methods, definitions, outcomes and associated factors. Results are summarised with descriptive statistics.

results288 studies met inclusion criteria, with 170 studies on RA, 19 on PsA, 49 on AS and 60 on SLE. Most studies were cross-sectional, with Europe and Asia having the greatest output. Most papers reported on osteoporosis and fractures as outcomes, with only 27 reporting falls, of which 24 were in RA. Participants' demographics and disease-related parameters were the most frequently explored potential associated factors.

conclusionsRA was the most well-studied CIRD with regard to the epidemiology and associated factors for osteoporosis, fractures and falls. Cross-sectional was the most common study design, with a higher proportion of cohort studies in RA. There is a paucity of studies assessing falls in CIRDs other than RA. Future observational research should be conducted with large prospective CIRD cohorts, with falls as an outcome and associated factor for fractures. This may enable better understanding of the risk and consequences of osteoporosis, fractures and falls, which may improve preventive care.