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High incidence of clinical fragility fractures in postmenopausal women with rheumatoid arthritis. A case-control study

Abstract: Objectives To estimate the incidence of clinical fragility fractures in postmenopausal women with rheumatoid arthritis (RA) and analyze risk factors for fracture. Methods Incidence of clinical fragility fractures in 330 postmenopausal women with RA was compared to that of a control population of 660 age-matched postmenopausal Spanish women. Clinical fractures during the previous five years were recorded. We analyzed associations with risk factors for fracture in both populations and with disease-related variables in RA patients. Results Median age of RA patients was 64 years; median RA duration was eight years. Sixty-nine percent were in remission or on low activity. Eighty-five percent had received glucocorticoids (GCs); 85 %, methotrexate; and 40 %, ?1 biologic DMARD. Fifty-four patients and 47 controls had ?1 major osteoporotic fracture (MOF). Incidence of MOFs was 3.55 per 100 patient-year in patients and 0.72 in controls (HR: 2.6). Risk factors for MOFs in RA patients were age, previous fracture, parental hip fracture, years since menopause, BMD, erosions, disease activity and disability, and cumulative dose of GCs. Previous fracture in RA patients was a strong risk for MOFs (HR: 10.37). Conclusion Of every 100 postmenopausal Spanish women with RA, 3?4 have a MOF per year. This is more than double that of the general population. A previous fracture poses a high risk for a new fracture. Other classic risk factors for fracture, RA disease activity and disability, and the cumulative dose of GCs are associated with fracture development.

 Fuente: Bone, 2023, 168, 116654

 Editorial: Elsevier

 Fecha de publicación: 01/01/2023

 Nº de páginas: 7

 Tipo de publicación: Artículo de Revista

 DOI: 10.1016/j.bone.2022.116654

 ISSN: 8756-3282,1873-2763

 Url de la publicación: https://doi.org/10.1016/j.bone.2022.116654

Autoría

GÓMEZ-VAQUERO, CARMEN

HIDALGO CALLEJA, CRISTINA

MARTÍNEZ LÓPEZ, JUAN ANTONIO

ARBOLEYA, LUIS

AGUILAR DEL REY, FRANCISCO JAVIER

MARTÍNEZ PARDO, SILVIA

ROS VILAMAJÓ, INMACULADA

SURÍS ARMANGUÉ, XAVIER

GRADOS, DOLORS

BELTRÁN AUDERA, CHESÚS

SUERO-ROSARIO, EVELYN

GÓMEZ GRACIA, INMACULADA

SALMORAL CHAMIZO, ASUNCIÓN

MARTÍN-ESTEVE, IRENE

FLÓREZ, HELENA

NARANJO, ANTONIO

CASTAÑEDA, SANTOS