Spondyloarthritis & psoriatic arthritis
Trends in Fracture Rates Over Two Decades Among Veterans With Ankylosing Spondylitis
Authors' conclusion
Fracture rates have increased over time for both AS and non-AS comparators. The fracture rate in individuals with AS did not decrease after TNFi introduction in 2003.
Study context
- Population
- Veterans in the national Veterans Affairs database, 2000–2020; Ankylosing spondylitis (AS) mean age 53 years, 92% male; comparators mean age 60 years, 89% male
- Participants
- 3,794 vs 1,152,805
- Exposure
- AS vs non-AS comparators; pre-TNFi era vs tumor necrosis factor inhibitors (TNFi) era
- ASn = 3,794
- Comparatorsn = 1,152,805reference
- Outcome
- Fracture incidence rate
Methodological detailsinterrupted time series analysis, direct standardization to the 2017 cohort structure, national Veterans Affairs database
- Interrupted time series analysis
- Direct standardization to the 2017 cohort structure
- National Veterans Affairs database
Main finding
As reported in the abstract
Fracture incidence rate, AS · 2000 to 2020
AS fracture incidence rate in 2000
7.9/1,000 person-years
AS fracture incidence rate in 2020
21.6/1,000 person-years
Observational data: associations, not effects.
Further findings
Fracture rate in AS, TNFi era vs pre-TNFi era (interrupted time series)
- Nonsignificantly increased in the TNFi era vs the pre-TNFi era
Original publication
Trends in Fracture Rates Over Two Decades Among Veterans With Ankylosing Spondylitis. Arthritis Care Res (Hoboken). Published 22 August 2023. doi:10.
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