Rheumatoid arthritis and subsequent fracture risk: an individual person meta-analysis to update FRAX
Pooled result · Any clinical fractureResult — go to the resultHazard ratio 1.49 95% CI 1.35–1.65Authors' conclusion
A diagnosis of RA confers an increased risk of fracture that is largely independent of BMD, sex, and corticosteroids.
Study context
- Population
- Men and women aged 20–116 years from 29 prospective cohorts with rheumatoid arthritis (RA) prevalence 3% or less (primary analysis); additional 17 cohorts with prevalence >3% (supplementary analysis)
- Participants
- 1,909,896 men29 prospective cohorts
- Comparison
- RA vs no RA
- Outcome
- Any clinical fracture
Methodological detailsinternational, individual person meta-analysis, random-effects meta-analysis, extension of Poisson regression model
- International
- Individual person meta-analysis
- Random-effects meta-analysis
- Extension of Poisson regression model
Pooled result
As reported in the abstract
Hazard ratio
1.49
95% CI 1.35–1.65
RAvs No RA
HR 1.49 (95% CI 1.35–1.65)
Further pooled results
| Outcome | HR (95% CI) | |
|---|---|---|
| Hip fracture | 2.23 (1.85–2.69) | |
| 0.20.5125Hazard ratio (log scale) |
- Hip fracture: 27,518 hip fractures
Hip fracture
- Significant interaction with age, higher HRs at younger ages
Osteoporotic fracture and major osteoporotic fracture (MOF)
- HRs of similar magnitude to any clinical fracture
By sex, glucocorticoid exposure and femoral neck bone mineral density (BMD)
- HRs did not differ between men and women and were independent of GC exposure and femoral neck BMD
Supplementary analysis cohorts (RA prevalence >3%)
- Lower HRs, particularly with high apparent RA prevalence, possibly from conflation of RA with OA
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Rheumatoid arthritis and subsequent fracture risk: an individual person meta-analysis to update FRAX. Osteoporos Int. Published 16 February 2025. doi:10.
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