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Osteoporotic fracture risk increased for young women with rheumatoid arthritis

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Women younger than 50 years of age with rheumatoid arthritis face an increased risk of osteoporotic fractures, according to a study from the Mayo Clinic presented at the American College of Rheumatology and the Association of Rheumatology Health Professionals Scientific Meeting 2011.

Young men with rheumatoid arthritis (RA) are also at an increased risk, but not until they are over age 50 years, the researchers reported.

“The risk for fractures among younger women and men with RA is not well established,” the researchers wrote in their abstract.

Investigators conducted a study of 1,155 RA patients for risk of RA by sex and age. They matched the study patients with controls of equal sex and age. They found fractures through inpatient and outpatient medical records and excluded severe trauma fractures. They compared the study cohort to controls for risk of osteoporotic fractures, stratifying by sex, using the Cox proportional hazards model. Follow-up ended at death or until date of last follow-up. They then stratified patients by age at rheumatoid arthritis diagnosis.

The researchers found 205 women and 67 men suffered osteoporotic fractures, while 276 women and 87 men had any other type of fracture.

“Women and men with RA were at increased risk for fracture relative to controls, regardless of age stratification at diagnosis,” the authors wrote. However, when stratified by age, fracture risk in men was not statistically significant. When they limited fracture risk to age 50 years in women, the hazard ratio was 6.7, with 13 women diagnosed with at least one osteoporotic fracture compared to two in controls. The hazard ratio for other fractures was 1.9, with 31 women suffering at least one compared to 17 in controls. Hazard ratios in men were not statistically significant.

“Understanding what contributes to the risk for fractures for all with rheumatoid arthritis, including young women, would help us better prevent them,” Shreyasee Amin, MD, who presented the study, stated in a news release.

References:

• Amin S, Gabriel SE, Achenbach SJ, Atkinson EJ, Melton III J. Fracture risk is increased in women with rheumatoid arthritis. Paper #1632. Presented at the ACR/ARHP Scientific Meeting 2011. Nov. 5-9. Chicago.
• Disclosure: Amin receives consulting fees from Merck Pharmaceuticals.

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