Psoriatic arthritis (PsA) is a type of inflammatory arthritis that occurs in about 10 percent to 20 percent of people with psoriasis. PsA may affect more than your skin and joints, and several comorbidities (co-occurring conditions) are linked with PsA. Among these comorbidities is osteoporosis, a bone disease that causes the bones to become fragile and break easily.
There are typically no symptoms in the early stages of osteoporosis, which may also be referred to as osteopenia. The first sign or symptom of osteoporosis is typically a bone fracture, a curving spine, or the loss of height.
Compared to the general population, people with PsA have a greater risk of developing osteoporosis. The prevalence of osteoporosis may be as high as 46 percent in people with PsA, and rates in the general population are approximately 10 percent to 20 percent.
This article covers the relationship between PsA and osteoporosis, as well as ways to manage and treat these conditions.
There are some possible explanations for the connection between PsA and osteoporosis.
Medications used to treat psoriatic disease may also contribute to bone loss and osteoporosis.
For instance, corticosteroids that are typically prescribed for treating inflammation have a potential side effect of bone thinning. Experts have studied the effects of antipsoriatic drugs (such as methotrexate) and found them to cause abnormal bone formation and resorption (breakdown). Immunosuppressive agents (such as cyclosporin A) have also been shown to increase the risk of osteoporosis. One study found that cyclosporin A interferes with the bone’s metabolism, including bone growth, bone degradation, and absorption of calcium.
Speak with your doctor about the potential side effects of your PsA medications and have preventive tests or screenings for bone density. People who have taken steroids for several months or longer should also speak with their doctor regarding their bone health.
The relationship between vitamin D and certain cytokines (proteins involved in inflammation) may contribute to PsA and osteoporosis. Together, vitamin D and cytokines help to maintain and regulate the functions of the skin and bones.
Vitamin D deficiency is a known risk factor for osteoporosis and may also be involved in PsA. One study found that chronic inflammation in PsA was also associated with a deficiency of vitamin D, as well as the overproduction of cytokines. Too little vitamin D and too many inflammatory cytokines likely contribute to the loss of bone mineral density and lead to the development of osteoporosis in people with PsA. Experts are uncertain whether vitamin D and cytokines work together or control each other’s functions.
Additional risk factors that may increase a person’s risk of developing osteoporosis associated with PsA include:
If you have PsA and risk factors for osteoporosis, talk to your health care provider to get bone density scans earlier and more frequently.
Several approaches may help you decrease your risk of osteoporosis if you have PsA.
Some risk factors for osteoporosis are preventable with lifestyle changes, including:
Dealing with osteoporosis associated with PsA may feel overwhelming at times. However, you are not alone. MyPsoriasisTeam is the social network for people with psoriasis and psoriatic arthritis. Here, more than 99,000 members come together to ask questions, offer support and advice, and meet others who understand life with psoriatic disease.
Do you have osteoporosis with your PsA? Share your experience and tips in the comments below or by posting on MyPsoriasisTeam.