FRI0466 RISK FACTORS ASSOCIATED WITH THE DEVELOPMENT OF FRACTURES IN GLUCOCORTICOID TREATED PATIENTS. THE ROLE OF HYPOGONADISM

Background Glucocorticoid-induced osteoporosis (GIOP) is a common form of secondary osteoporosis (OP). Fractures in GIOP frequently occur with higher bone mineral density (BMD) than expected and typically at treatment initiation, complicating the identification of patients at risk for fracture. Objectives Identify risk factors associated with fragility fracture development in GC-treated patients. Methods 127 patients (aged 62±18years, 63% women, 46% postmenopausal) on GC treatment (prednisone ≥5mg/day, >3months) were included. Clinical data collected included: risk factors for OP and fractures, dose and GC-treatment duration, previous fractures and disease activity, anthropometric data, bone metabolism parameters (including gonadal axis study), BMD analysis (DXA; OP: T-score ≤-2.5), TBS (degraded microarchitecture [DMA]: 1 . Results Most patients received GC treatment for vasculitis or polymyalgia rheumatica during 47.7±69 months (mean daily dose: 14.5mg). 17% had VF, 28% had fragility fracture (VF + non-VF), 29% OP and 71% DMA. Patients with VF received more GC-boluses (57.1% vs. 29.5%,p=0.03), were older (68±13 vs. 60±19 years, p=0.02), postmenopausal (100% vs. 67%, p=0.015) and/or men with testosterone 100, p=0.01) and having received GC-boluses (OR 3.40; IC95% 1-11.8, p=0.01) were the principal factors associated with VF. Hypogonadism (OR 7.1; IC95% 1.5-38.7, p=0.01) and having a FRAX >20 (OR 6.97; IC95% 1.3-51.7, p=0.02) were factors related to the presence of fragility fractures. Men with testosterone Conclusion Hypogonadism is a major risk factor for developing fractures in GC-treated men and women, whereas receiving GC-boluses is related to VF, indicating the importance of evaluating the gonadal axis in these patients. References [1] Buckley L, et al. Arthritis Care Res. 2017 Disclosure of Interests Helena Florez: None declared, Jose Hernandez-Rodriguez : None declared, Africa Muxi: None declared, Josep Lluis Carrasco: None declared, Sergio Prieto-Gonzalez: None declared, Silvia Ruiz-Gaspa : None declared, Maria C. Cid Grant/research support from: Kiniksa Pharmaceuticals, Consultant for: Roche, GSK, Janssen, Abbvie, Speakers bureau: Boehringer-Inhelheim, Vifor, Ana Monegal Speakers bureau: Eli Lilly, Amgen, Nuria Guanabens Consultant for: Advisory Boards from Amgen, Alexion and UCB, Speakers bureau: Fees and lectures from Eli Lilly, Pilar Peris Speakers bureau: Personal Fees and Non-financial support (attendance to congresses) from Amgen and Eli Lilly