Are young women and men with rheumatoid arthritis at risk for fragility fractures? A population-based study

Shreyasee Amin, Sherine E. Gabriel, Sara J. Achenbach, Elizabeth J. Atkinson, L. Joseph Melton

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objective. Older women and men with rheumatoid arthritis (RA) are at increased risk for fractures, but limited information is available on fracture risk in younger individuals with RA and whether such risk occurs early in the disease onset or only when older. We determined the risk for fractures in both young and older women and men following RA diagnosis. Methods. We studied a population-based inception cohort with RA from Olmsted County, Minnesota, USA. We identified 822 women and 349 men diagnosed with RA between 1955 and 2007 (308 women and 110 men diagnosed before age 50) and an equal number of paired non-RA subjects, matched by sex and birth year. Incident fractures were collected through review of complete (inpatient and outpatient) medical records available through the linkage system of the Rochester Epidemiology Project. Results. The hazard ratio (HR; 95% CI) for a non-pathologic fracture occurring from no more than moderate trauma was 1.63 (1.36-1.96) for women and 1.40 (1.02-1.93) for men with RA. Findings were consistent for women and men diagnosed with RA at age ≥ 50 years [HR, 1.43 (1.16-1.77) and 1.34 (0.92-1.94), respectively], or at age < 50 years [HR, 2.34 (1.61-3.42) and 1.74 (0.91-3.30), respectively]. However, young women, but not young men, with RA were at increased fracture risk even before age 50 years (HR, 1.95 [1.08-3.51] and 0.82 [0.28-2.45], respectively). Conclusion. Young men with RA are at increased risk for fractures only when older, whereas young women with RA have an elevated fracture risk even while still young.

Original languageEnglish (US)
Pages (from-to)1669-1676
Number of pages8
JournalJournal of Rheumatology
Volume40
Issue number10
DOIs
StatePublished - Oct 2013

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Rheumatoid Arthritis
Population
Arthritis
Medical Records
Inpatients
Epidemiology
Outpatients
Parturition
Wounds and Injuries

Keywords

  • Bone fractures
  • Epidemiology
  • Osteoporosis
  • Rheumatoid arthritis

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Immunology and Allergy

Cite this

Are young women and men with rheumatoid arthritis at risk for fragility fractures? A population-based study. / Amin, Shreyasee; Gabriel, Sherine E.; Achenbach, Sara J.; Atkinson, Elizabeth J.; Joseph Melton, L.

In: Journal of Rheumatology, Vol. 40, No. 10, 10.2013, p. 1669-1676.

Research output: Contribution to journalArticle

Amin, Shreyasee ; Gabriel, Sherine E. ; Achenbach, Sara J. ; Atkinson, Elizabeth J. ; Joseph Melton, L. / Are young women and men with rheumatoid arthritis at risk for fragility fractures? A population-based study. In: Journal of Rheumatology. 2013 ; Vol. 40, No. 10. pp. 1669-1676.
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abstract = "Objective. Older women and men with rheumatoid arthritis (RA) are at increased risk for fractures, but limited information is available on fracture risk in younger individuals with RA and whether such risk occurs early in the disease onset or only when older. We determined the risk for fractures in both young and older women and men following RA diagnosis. Methods. We studied a population-based inception cohort with RA from Olmsted County, Minnesota, USA. We identified 822 women and 349 men diagnosed with RA between 1955 and 2007 (308 women and 110 men diagnosed before age 50) and an equal number of paired non-RA subjects, matched by sex and birth year. Incident fractures were collected through review of complete (inpatient and outpatient) medical records available through the linkage system of the Rochester Epidemiology Project. Results. The hazard ratio (HR; 95{\%} CI) for a non-pathologic fracture occurring from no more than moderate trauma was 1.63 (1.36-1.96) for women and 1.40 (1.02-1.93) for men with RA. Findings were consistent for women and men diagnosed with RA at age ≥ 50 years [HR, 1.43 (1.16-1.77) and 1.34 (0.92-1.94), respectively], or at age < 50 years [HR, 2.34 (1.61-3.42) and 1.74 (0.91-3.30), respectively]. However, young women, but not young men, with RA were at increased fracture risk even before age 50 years (HR, 1.95 [1.08-3.51] and 0.82 [0.28-2.45], respectively). Conclusion. Young men with RA are at increased risk for fractures only when older, whereas young women with RA have an elevated fracture risk even while still young.",
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T1 - Are young women and men with rheumatoid arthritis at risk for fragility fractures? A population-based study

AU - Amin, Shreyasee

AU - Gabriel, Sherine E.

AU - Achenbach, Sara J.

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AU - Joseph Melton, L.

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N2 - Objective. Older women and men with rheumatoid arthritis (RA) are at increased risk for fractures, but limited information is available on fracture risk in younger individuals with RA and whether such risk occurs early in the disease onset or only when older. We determined the risk for fractures in both young and older women and men following RA diagnosis. Methods. We studied a population-based inception cohort with RA from Olmsted County, Minnesota, USA. We identified 822 women and 349 men diagnosed with RA between 1955 and 2007 (308 women and 110 men diagnosed before age 50) and an equal number of paired non-RA subjects, matched by sex and birth year. Incident fractures were collected through review of complete (inpatient and outpatient) medical records available through the linkage system of the Rochester Epidemiology Project. Results. The hazard ratio (HR; 95% CI) for a non-pathologic fracture occurring from no more than moderate trauma was 1.63 (1.36-1.96) for women and 1.40 (1.02-1.93) for men with RA. Findings were consistent for women and men diagnosed with RA at age ≥ 50 years [HR, 1.43 (1.16-1.77) and 1.34 (0.92-1.94), respectively], or at age < 50 years [HR, 2.34 (1.61-3.42) and 1.74 (0.91-3.30), respectively]. However, young women, but not young men, with RA were at increased fracture risk even before age 50 years (HR, 1.95 [1.08-3.51] and 0.82 [0.28-2.45], respectively). Conclusion. Young men with RA are at increased risk for fractures only when older, whereas young women with RA have an elevated fracture risk even while still young.

AB - Objective. Older women and men with rheumatoid arthritis (RA) are at increased risk for fractures, but limited information is available on fracture risk in younger individuals with RA and whether such risk occurs early in the disease onset or only when older. We determined the risk for fractures in both young and older women and men following RA diagnosis. Methods. We studied a population-based inception cohort with RA from Olmsted County, Minnesota, USA. We identified 822 women and 349 men diagnosed with RA between 1955 and 2007 (308 women and 110 men diagnosed before age 50) and an equal number of paired non-RA subjects, matched by sex and birth year. Incident fractures were collected through review of complete (inpatient and outpatient) medical records available through the linkage system of the Rochester Epidemiology Project. Results. The hazard ratio (HR; 95% CI) for a non-pathologic fracture occurring from no more than moderate trauma was 1.63 (1.36-1.96) for women and 1.40 (1.02-1.93) for men with RA. Findings were consistent for women and men diagnosed with RA at age ≥ 50 years [HR, 1.43 (1.16-1.77) and 1.34 (0.92-1.94), respectively], or at age < 50 years [HR, 2.34 (1.61-3.42) and 1.74 (0.91-3.30), respectively]. However, young women, but not young men, with RA were at increased fracture risk even before age 50 years (HR, 1.95 [1.08-3.51] and 0.82 [0.28-2.45], respectively). Conclusion. Young men with RA are at increased risk for fractures only when older, whereas young women with RA have an elevated fracture risk even while still young.

KW - Bone fractures

KW - Epidemiology

KW - Osteoporosis

KW - Rheumatoid arthritis

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