TY - JOUR
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.
AU - Atkinson, Elizabeth J.
AU - Joseph Melton, L.
PY - 2013/10
Y1 - 2013/10
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
UR - http://www.scopus.com/inward/record.url?scp=84885088716&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84885088716&partnerID=8YFLogxK
U2 - 10.3899/jrheum.121493
DO - 10.3899/jrheum.121493
M3 - Article
C2 - 23950189
AN - SCOPUS:84885088716
SN - 0315-162X
VL - 40
SP - 1669
EP - 1676
JO - Journal of Rheumatology
JF - Journal of Rheumatology
IS - 10
ER -