Younger Patients with RA at Greater Risk of Fracture Even Before Age 50 Years

Sarfaroj Khan 

Disclosures

February 17, 2021

Takeaway

  • Patients with rheumatoid arthritis (RA) below age 50 years were at an increased risk of fracture compared with those without RA.

  • The incidence rate of first fracture before age 50 years was significantly higher in women and not in men with RA.

Why this matters

  • The increase in the risk of first fracture for patients with RA before age 50 years has potential implications for how the risk of fracture is managed in younger aged patients with RA.

Study design

  • A retrospective observational study of RA cases (n=36,858) and matched controls (n=110,574) using data from the UK Clinical Practice Research Datalink of adults aged ≥18 years with a diagnosis of RA.

  • Funding: Pfizer competitive I-CRP funding programme.

Key results

  • The rate of first fractures was significantly higher in patients with RA vs matched controls in all age groups (incidence rate ratio [IRR], 1.37; 95% CI, 1.32-1.42) including those aged below 50 years at diagnosis (IRR, 1.36; 95% CI, 1.25-1.49).

  • The rate of subsequent fracture was also higher for all age groups (IRR, 1.13; 95% CI, 1.05-1.22) including those aged below 50 years (IRR, 1.30; 95% CI, 1.05-1.60).

  • This difference was true for both men and women.

  • Compared with controls, the rate of first fracture before age 50 years was significantly higher in women (IRR, 1.29; 95% CI, 1.12-1.49) and not in men (IRR, 1.15; 95% CI, 0.92-1.43) diagnosed with RA before age 50 years.

  • The rate of subsequent fracture before age 50 years was not significantly higher in both men (IRR, 1.25; 95% CI, 0.63-2.38) and women (IRR, 1.27; 95% CI, 0.83-1.91) diagnosed with RA before age 50 years.

  • Considering age at diagnosis, gender, glucocorticoid steroid use, fracture previous to index date, osteoporosis diagnosis, smoking, alcohol and bisphosphonate diagnosis, the risk of first fracture before age 50 years remained significantly higher in those with RA vs matched controls.

Limitations

  • Retrospective design.

 

Erwin J, Enki DG, Woolf AD. Younger people with rheumatoid arthritis are at increased risk of fracture even before age 50 years: a population-based cohort study. Osteoporos Int. 2021 Feb 11 [Epub ahead of print]. doi: 10.1007/s00198-021-05862 View abstract

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.

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