Significant Association Identified Between Psoriatic Arthritis and Increased Risk of Vertebral Fracture

A Doctor reviewing her patients x-ray results for possibly breaks, fractures and abnormalities
Researchers conducted a systematic review and meta-analysis to assess the impact of inflammatory burden on risk for vertebral fracture.

The following article is a part of conference coverage from the American College of Rheumatology (ACR) Convergence 2021, being held virtually from November 3 to 10, 2021. The team at Rheumatology Advisor will be reporting on the latest news and research conducted by leading experts in rheumatology. Check back for more from the ACR Convergence 2021.


Outcomes of a recent systematic review and meta-analysis revealed a significantly increased risk for prevalent vertebral fracture among patients with psoriatic arthritis (PsA), according to a presentation at the American College of Rheumatology (ACR) Convergence 2021, held November 3-10, 2021.

Although an increased risk for vertebral fracture risk has been identified in high-inflammatory-burden diseases such as rheumatoid arthritis, the risk among lower-inflammatory-burden diseases such as psoriatic arthritis is unclear.  A team of investigators therefore conducted the aforementioned study to identify the prevalence of vertebral fracture among patients with and without PsA.

Using MEDLINE and EMBASE databases, the terms psoriatic arthritis and vertebral fracture were searched to identify studies published through December 2020. Eligibility criteria included the use of a PsA cohort and a comparator cohort without PsA; assessment of the prevalence of vertebral fracture in both cohorts; and the inclusion of odds ratios (ORs) with 95% confidence intervals (95% CIs) comparing vertebral fracture prevalence between groups or the availability of sufficient data for the investigators to calculate ORs. The generic inverse variance method was used to combine the point estimates with standard errors retrieved from each study. Publication bias was assessed using a funnel plot.

Out of a total of 26,090 identified articles, 5 cohort studies met inclusion criteria. The investigators identified a significant association between PsA and vertebral fracture with a pooled OR of 2.09 (95% CI, 1.11-3.96; I2=70%). There was no evidence of publication bias in the studies evaluated.

The investigators conclude, “This systematic review and meta-analysis found a significantly increased risk of prevalent VF among patients with PsA.”


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Ungprasert P, Charoenngam N, Ponvilawan B, Thongpiya J, Yingchoncharoen P. Increased risk of vertebral fracture among patients with psoriatic arthritis: a systematic review and meta-analysis. Presentation at: ACR Convergence 2021; November 3-10, 2021; virtual. Abstract 1304.