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Background <p>Patients with radiographic axial spondyloarthritis (r-axSpA) are at an increased risk of osteoporotic fractures compared to the general population.</p> Aim <p>To evaluate the clinical utility of trabecular bone score (TBS) compared with bone mineral density (BMD) for predicting major osteoporotic fractures (MOF) in patients with radiographic axial spondyloarthritis (r-axSpA).</p> Methods <p>A total of 63 patients with r-axSpA were included. At baseline, lumbar spine DXA, thoracic and lumbar spine X-rays, and basic demographic data were collected. Patients were followed for 3 years, after which new major osteoporotic fractures (MOF) and follow-up spine X-rays were recorded.</p> Results <p>During the observation period, 7 patients experienced MOF. Of these, 6 had been classified at high risk based on TBS (TBS ≤ 1.31). On the other hand, only 1 was identified as osteopenic and none as osteoporotic based on BMD T-scores. Strongest relative risk (RR) factors for MOF included a prior MOF (RR = 13.3; <i>p</i> &lt; 0.001) and presence of syndesmophytes/ankylosis (RR = 2.0; <i>p</i> = 0.020). Low TBS (≤ 1.31) was associated with a RR of 4.5 (hence being only a trend due to low numbers). BMD T-score &lt; − 1.0 seemed to be not helpful in this cohort (RR = 0.64).</p> Conclusion <p>TBS may provide greater clinical value than BMD in identifying r-axSpA patients at increased risk of MOF. Despite limited sample size, these findings highlight the potential of TBS as a complementary diagnostic tool in routine practice.</p>

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Prognostic value of trabecular bone score for major osteoporotic fractures in patients with radiographic axial spondyloarthritis: a 3-year prospective cohort study

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  • 发表日期：

    2025年11月6日

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  • Paweł Żuchowski,
  • Marta Dura,
  • Daniel Jeka,
  • Katarzyna Gajewicz-Sawicka,
  • Michał Kułakowski,
  • Burkhard Muche

摘要

Background

Patients with radiographic axial spondyloarthritis (r-axSpA) are at an increased risk of osteoporotic fractures compared to the general population.

Aim

To evaluate the clinical utility of trabecular bone score (TBS) compared with bone mineral density (BMD) for predicting major osteoporotic fractures (MOF) in patients with radiographic axial spondyloarthritis (r-axSpA).

Methods

A total of 63 patients with r-axSpA were included. At baseline, lumbar spine DXA, thoracic and lumbar spine X-rays, and basic demographic data were collected. Patients were followed for 3 years, after which new major osteoporotic fractures (MOF) and follow-up spine X-rays were recorded.

Results

During the observation period, 7 patients experienced MOF. Of these, 6 had been classified at high risk based on TBS (TBS ≤ 1.31). On the other hand, only 1 was identified as osteopenic and none as osteoporotic based on BMD T-scores. Strongest relative risk (RR) factors for MOF included a prior MOF (RR = 13.3; p < 0.001) and presence of syndesmophytes/ankylosis (RR = 2.0; p = 0.020). Low TBS (≤ 1.31) was associated with a RR of 4.5 (hence being only a trend due to low numbers). BMD T-score < − 1.0 seemed to be not helpful in this cohort (RR = 0.64).

Conclusion

TBS may provide greater clinical value than BMD in identifying r-axSpA patients at increased risk of MOF. Despite limited sample size, these findings highlight the potential of TBS as a complementary diagnostic tool in routine practice.