Young Women With RA at High Risk for Fractures

Martha Kerr

November 05, 2011

November 5, 2011 (Chicago, Illinois) — Mayo clinic researchers in Rochester, Minnesota, reported here at the American College of Rheumatology (ACR) 2011 Annual Meeting that women with rheumatoid arthritis (RA) who are younger than 50 years of age are already at increased risk for fractures, unlike their male counterparts with RA.

Rheumatologist Shreyasee Amin, MD, and colleagues studied 2 groups of adults (n = 1155 in each group) from the same community. One group was newly diagnosed with RA, and the other did not have RA.

Participants were matched by sex and birth year. Medical records were examined over time for new fractures unrelated to cancer or severe trauma. In women and men with RA, new fractures were more likely than in their counterparts, regardless of their age at RA diagnosis. 

Women younger than 50 years of age at RA diagnosis (304 women; mean age at diagnosis, 39 years) were more likely than their counterparts without RA to have their first new fracture even before age 50. Men with RA were also at increased risk for fractures, but that risk was not evident until they were older than age 50.

"Women and men with RA were at increased risk for fracture relative to controls, regardless of age stratification at diagnosis, although that did not reach statistical significance in men when stratified by age," the researchers state in their abstract.

When follow-up was limited to age 50 years, the hazard ratio (HR) for osteoporotic fracture was 6.7 (95% confidence interval [CI], 1.5 - 29.5), with 13 women having at least 1 osteoporotic fracture (7/1000 person-years) compared with 2 (1/1000 person-years) in matched controls.

The HR for any fracture was 1.9 (95% CI, 1.04 - 3.4), with 31 women with RA having at least 1 fracture (16/1000 person-years) vs 17 fractures (9/1000 person-years) in matched controls.

In men with RA younger than 50 years of age (n = 109; mean age, 41 years), too few had a fracture before age 50 years (n = 2 with osteoporotic fracture, n = 5 for any fracture) to draw any "robust conclusions" on fracture risk relative to controls, the researchers say in their abstract.

"Understanding what contributes to the risk for fractures for all with rheumatoid arthritis, including young women, would help us better prevent them," Dr. Amin says in an ACR release. Women with RA younger than age 50 need to know that even though they are young, they need to take greater care to prevent fractures, she says.

Disclosure information was not available on the authors at press time.

American College of Rheumatology 2011 Annual Meeting; Abstract #1632. To be presented Monday November 7, 2011.

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