Clin Osteol 2026; 31(3): 153-159 | DOI: 10.36290/clo.2026.023

Systemic lupus erythematosus and fracture riskReview articles

Pavol Masaryk

Národný ústav reumatických chorôb, Piešťany

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease associated with persistent systemic inflammation, organ damage, cumulative exposure to glucocorticoids, and frequent comorbidities (vitamin D deficiency, renal involvement, premature menopause, low physical activity). These factors contribute to disturbances in bone metabolism, a reduction in bone mineral density (BMD), and an increased risk of both vertebral and non-vertebral fractures. Osteoporosis is the second most common comorbidity in SLE. Its prevalence is several times higher compared with the healthy population. Vertebral fractures are often asymptomatic, remain undiagnosed for a long time, and may occur even at BMD values within the osteopenic range or normal limits. Patients with SLE and vertebral deformities have significantly lower TBS than patients without fractures; TBS discriminates the risk of vertebral fractures better than BMD alone. The FRAX® tool underestimates the 10-year fracture risk in patients with SLE, particularly for vertebral fractures.

Keywords: systemic lupus erythematosus, osteoporosis, bone mineral density, fractures, TBS score, FRAX®.

Accepted: September 15, 2026; Published: October 8, 2026  Show citation