Rheumatoid arthritis

First fracture in rheumatoid arthritis: analysis by fracture site, gender, age, and comorbidities

Osteoporos IntPublished Retrospective cohort study

Main finding · First fracture, IR per 1000 PY (2000–2010)Result — go to the resultIncidence rate ratio 1.32 CI 1.10–1.60

Authors' conclusion

After age, gender, and comorbidity adjustment, RA is associated with a 32% higher incidence of first fracture, increased MOF, and a fracture incidence that is already increased before a first recorded RA diagnosis.

Study context

Population
Rheumatoid arthritis (RA) patients and matched hospitalised controls, West Australian Rheumatic Disease Epidemiological Registry (WARDER), 1980–2015
Exposure
RA vs matched hospitalised controls free of rheumatic disease
Outcome
Incidence of first fracture (IR per 1000 PY)
Methodological detailslongitudinal, routinely collected administrative data, matched on age, gender and comorbidities (Charlson Comorbidity Index)
  • Longitudinal
  • Routinely collected administrative data
  • Matched on age, gender and comorbidities (Charlson Comorbidity Index)

Main finding

First fracture, IR per 1000 PY (2000–2010)

Incidence rate ratio

1.32

CI 1.10–1.60

By group

RA

18.3

Incidence rates (IR) · CI 15.7–21.2 · per 1000 person years (PY)

RAvs Controls
IRR 1.32 (CI 1.10–1.60)

As reported in the abstract

Observational data: associations, not effects.

Further findings

IR, per 1000 PY

OutcomeRAEstimate
Upper limb fracture, IR per 1000 PY5.56 (95% CI 4.18–7.26)IRR 1.18 (95% CI 0.84–1.65)
Lower limb fracture, IR per 1000 PY10.60 (95% CI 8.66–12.87)IRR 1.44 (95% CI 1.19–1.86)
Axial fracture, IR per 1000 PYCI as printed does not contain the point estimate2.47 (95% CI 2.58–3.68)IRR 1.01 (95% CI 0.61–1.63)
First fracture before first RA hospital record · 6 years before first RA hospital recordRR 1.58 (CI 1.05–2.39)

Original publication

First fracture in rheumatoid arthritis: analysis by fracture site, gender, age, and comorbidities. Osteoporos Int. Published 12 November 2024. doi:10.1007/s00198-024-07311-1

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