Screening of osteoporosis in patients with ANCA-associated vasculitis (AAV) is quite low: results from a country-wide study

Patients with ANCA-associated vasculitis (AAV) are at increased risk of osteoporosis due to multiple disease- and treatment-related factors. However, real-world data on osteoporosis screening practices in this population remain limited. The aim of this study was to assess osteoporosis screening practices and the prevalence of reduced bone mineral density (BMD) in patients with AAV using a nationwide registry, and to identify factors associated with osteoporosis. This nationwide, retrospective, web-based study was conducted using the Turkish Vasculitis Study Group (TRVaS) database, including patients diagnosed with AAV between January 2000 and December 2023. Patients were evaluated for osteoporosis screening using dual-energy X-ray absorptiometry (DXA) and categorized according to BMD status. Clinical characteristics and potential risk factors were analyzed, and multivariable logistic regression was performed to identify independent predictors of osteoporosis. A total of 528 patients were included (median age 56 years interquartile range 43-66; 57.8% male). Of these, 36.2% underwent DXA screening; among screened patients, 40.8% had osteoporosis and 38.7% had osteopenia. In multivariable analysis, older age (odds ratio OR 1.03, p = 0.020) and the presence of at least one additional osteoporosis risk factor (OR 2.25, p = 0.049) were independently associated with osteoporosis. This nationwide registry-based study highlights a gap between the recognized risk of osteoporosis in patients with AAV and its implementation in real-world clinical practice. These findings underscore the need for improved screening and comprehensive bone health management strategies in this population.