Fracture prediction in rheumatoid arthritis: validation of FRAX with bone mineral density for incident major osteoporotic fractures
Authors' conclusion
FRAX predicts fracture risk in contemporary RA patients but may slightly overestimate risk in those already at high predicted risk.
Study context
- Population
- Patients receiving BMD testing, Manitoba Population Health Research Data Repository
- Participants
- 2,099 vs 2,099
- Exposure
- FRAX with BMD in RA vs non-RA patients
- RAn = 2,099
- Non-RAn = 2,099reference
- Outcome
- Calibration of FRAX-predicted (with BMD) vs observed 10-year major osteoporotic fracture (MOF) probability
- Follow-up
- 10 years
Methodological detailspopulation-based registry linkage, calibration and Cox regression analysis
- Population-based registry linkage
- Calibration and Cox regression analysis
Main finding
As reported in the abstract
10-year MOF risk, FRAX-predicted vs observed, and calibration slope
| Group | Value | FRAX-predicted 10-year risk | Calibration slope |
|---|---|---|---|
| RA | 13.2% (95% CI 11.6–15.1) | 13.2% | 0.67 (95% CI 0.53, 0.81) |
| Non-RA | 165 events | 0.98 (95% CI 0.61, 1.34) |
Value
RA13.2% (95% CI 11.6–15.1)
Non-RA165 events
FRAX-predicted 10-year risk
RA13.2%
Non-RA— not stated in the abstract
Calibration slope
RA0.67 (95% CI 0.53, 0.81)
Non-RA0.98 (95% CI 0.61, 1.34)
Observational data: associations, not effects.
Further findings
| Outcome | RA | Non-RA | P value |
|---|---|---|---|
| MOF risk stratification by FRAX (Cox regression)Slightly better performance in non-RA | P for interaction = 0.004 | ||
| HR | 1.52 (95% CI 1.25, 1.72) | 2.00 (95% CI 1.73, 2.31) |
Original publication
Fracture prediction in rheumatoid arthritis: validation of FRAX with bone mineral density for incident major osteoporotic fractures. Rheumatology (Oxford). Published 13 December 2023. doi:10.
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