Psoriasis and the bones: arthritis is not the only problem

In people with psoriatic arthritis (PsA), it is not only the joints that suffer: bone fractures and falls also occur more frequently, a recent study shows.

PsA and the impact on fractures and falls

• Data from 61 PsA patients and 69 controls.
• In the PsA group, femoral bone density was reduced and the likelihood of femoral neck fracture was increased.
• The psoriasis patients also had a higher prevalence of fractures and falls overall.
• Scalp involvement and late-onset psoriasis were associated with a higher prevalence of fractures.
• People with flexural psoriasis and late-onset disease fell more often than controls.

PsA leads to reduced bone density and associated complications

The current study from Hungary compared bone density, 10-year risk of fractures, number of fractures sustained and frequency of falls in people with psoriatic arthritis and healthy controls.

PsA sufferers had lower femoral bone density. The T-values of the vertebrae and femoral neck were also lower, which indicates reduced bone density. This was associated with an increased 10-year risk of hip fracture, which should come as no surprise to anyone. Both results were statistically significant.

Scalp involvement, flexural forms of psoriasis and late onset are risk factors

Study participants with PsA also generally suffered more bone fractures - including fractures of vertebral bodies or peripheral bones. There was also a higher incidence of falls compared to the control group. Interestingly, the authors of the study found that people with scalp involvement and late-onset psoriasis had a significantly higher prevalence of bone fractures.

A late first manifestation also predisposed to an increased risk of falls - the same applies to the presence of flexural psoriasis lesions. This result also showed statistical significance.

Educating patients comprehensively

In view of the data, it is important to monitor psoriasis patients not only for possible arthritis. They should also be made aware of the increased risk of falls. Physicians should assess the individual risk of fracture and determine bone density if necessary. This is especially true for people with scalp involvement or flexural psoriasis.