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Osteoporosis and Fragility Fractures Among SLE Patients. (FRAIL Trial)

Active, not recruiting
Conditions
Lupus Erythematosus, Systemic
Registration Number
NCT05590390
Lead Sponsor
Azienda Ospedaliera Universitaria Integrata Verona
Brief Summary

The trial is designed to evaluate prevalence of fragility fracture, their impact on quality of life of SLE patients and disease or treatment variables such as steroids dosage or use of specific drugs like hydroxychloroquine, DMARDs or belimumab. Patients will perform DXA evaluation, blood tests and PROs questionnaires. Moreover, the investigators want to correlate those variables to bone turnover markers and bone metabolism modulators. A secondary aim is also to assess the fracture risk of those patients as described by FRAX and DEFRA tools.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
300
Inclusion Criteria
  • SLE fulfilling 2019 ACR/EULAR or 2012 SLICC criteria
  • willing to perform DXA/ x-Ray investigation (common clinical practice)
  • willing to donate blood sample
  • willing to complete questionnaires
  • the patients should be in a stable disease activity.
Exclusion Criteria
  • Uncontrolled endocrinological disease.
  • metabolic bone disease other than osteoporosis ( e.g. Paget disease).
  • celiac disease, inflammatory bowel disease or pancreatic exocrine deficiency resulting in malabsorption
  • patients lacking medication history information (SLE and bone related medications).
  • Have any other clinically significant abnormal laboratory value in the opinion of the investigator
  • Have any intercurrent significant medical illness that the investigator considers would make the candidate unsuitable for the study.
  • The patients shouldn't be enrolled during a moderate to severe flare of disease requiring an escalation of therapy ( especially glucocorticoid) - no new BILAG A or B in the last 3 months.
  • Pregnant patients or during the first year after child birth.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
influence of SLE medication - immunosuppressant1 visit - 1 hour

The population will be analyzed grouping by presence or absence of fragility fracture in relation to medications variables such as difference in percentage percentage of immunosuppressant users

influence of SLE medication - biologics1 visit - 1 hour

The population will be analyzed grouping by presence or absence of fragility fracture in relation to medications variables such as difference in percentage of percentage of biologics ( e.g. belimumab) users.

FACIT-F1 visit - 1 hour

scores in fatigue as for questionnaire FACIT-F (Functional Assessment of Chronic Illness Therapy - Fatigue; min 0 - max 52, higher score less fatigue)

CQR51 visit - 1 hour

compliance questionnaire in rheumatology 5 items; adherent - not adherent to medication)

PGA1 visit - 1 hour

Patient global assessment ( VAS scale 0-10) higher score worse health

Prevalence of osteoporosis1 visit - 1 hour

percentage of patient with osteoporosis defined by WHO definition with T score

EQ5D1 visit - 1 hour

scores at questionnaire on quality of life EQ5D = EuroQol 5 dimension 5 L; (min 1-1-1-1-1, max 5-5-5-5-5 higher score worse + EQ VAS min 0, max 100 higher score better quality of life)

influence of SLE medication - glucocorticoid1 visit - 1 hour

The population will be analyzed grouping by presence or absence of fragility fracture in relation to medications variables such as difference in cumulative corticosteroid dose (mg)

Prevalence of fragility fractures1 visit 1 hour

percentage of patients with fragility fractures

SF-36 v21 visit - 1 hour

scores on quality of life with SF36 v2 (Short Form 36 version 2 Health Survey; min 0 - max 100, higher score better health)

HADS1 visit - 1 hour

scores on mood disorder scale HADS (Health Anxiety and Depression Scale; min 0 - Max 42, higher score worse anxiety)

influence of SLE medication - hydroxychloroquine1 visit - 1 hour

The population will be analyzed grouping by presence or absence of fragility fracture in relation to medications variables such as difference in percentage of hydroxychloroquine users.

Secondary Outcome Measures
NameTimeMethod
serum bone biomarkers - OPG1 visit - 1 hour

OPG (pg/ml level) in study population and difference by fracture status

serum bone biomarkers - RANKL1 visit - 1 hour

RANKL (pg/ml) level in study population and difference by fracture status

serum bone biomarkers - BAP1 visit - 1 hour

bone alkaline phosphatase (BAP) (ug/L) level in study population and difference by fracture status

serum bone biomarkers - CTX1 visit - 1 hour

C-terminal telopeptide of type I collagen (CTX) (ng/ml), level in study population and difference by fracture status

Descriptive statistics of study population - 11 visit - 1 hour

The population will be analyzed as whole and also grouping by presence or absence of fragility fracture in relation to clinical variables - SLE disease duration

Descriptive statistics of study population - 21 visit - 1 hour

The population will be analyzed as whole and also grouping by presence or absence of fragility fracture in relation to clinical variables - SDI ( SLICC Damage index - from 0, higher score higher disease damage accrual)

serum bone biomarkers - P1NP1 visit - 1 hour

N-terminal propeptide of type I procollagen - P1NP (ng/ml) level in study population and difference by fracture status

serum bone biomarkers - Dkk11 visit - 1 hour

Dkk1 (pmol/L) level in study population and difference by fracture status

Fracture risk calculation by DEFRA tool1 visit - 1 hour

DEFRA fracture risk assessment ( % risk major fracture in 10 yrs)

serum bone biomarkers - Sclerostin1 visit - 1 hour

sclerostin (pmol/L) level in study population and difference by fracture status

Fracture risk calculation by FRAX tool1 visit - 1 hour

FRAX fracture risk assessment ( % risk major fracture in 10 yrs)

Descriptive statistics of study population - 31 visit - 1 hour

The population will be analyzed as whole and also grouping by presence or absence of fragility fracture in relation to demographic variable - Age ( years)

Descriptive statistics of study population - 41 visit - 1 hour

The population will be analyzed as whole and also grouping by presence or absence of fragility fracture in relation to demographic variable - gender ( % females)

serum bone biomarkers - PTH1 visit - 1 hour

parathormone (PTH) pg/ml level in study population and difference by fracture status

serum bone biomarkers - vitamin D(OH)1 visit - 1 hour

25OH vitamin D (ng/ml), level in study population and difference by fracture status

Trial Locations

Locations (1)

AOUI Verona - UOC Reumatologia

🇮🇹

Verona, Italy

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