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Osteoporotic fracture risk may be overestimated using the UK FRAX algorithm for patients with RA
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An overestimation of the fracture risk for patients with rheumatoid arthritis compared to the general population was found using the U.K. fracture risk assessment tool for predicting the 10-year risk of hip or other major osteoporotic fracture, according to recently published data.
Researchers studied data from 11,582 patients with rheumatoid arthritis (RA) between the ages of 40 years and 90 years enrolled in the Clinical Practice Research Datalink (CPRD) in the United Kingdom between January 1987 and December 2013. Data included 297 reports of hip fracture and 808 reports of other major osteoporotic fracture. A matched cohort from the general population consisted of 38,755 individuals, including 536 with hip fractures and 1,925 with other major osteoporotic fractures.
Among the patients with RA, the FRAX overestimated the fracture risk in the CPRD group. The mean predicted compared with the observed risks for major osteoporotic fractures and hip fractures at 10 years were 13.3% vs. 8.4% and 5.5% vs. 3.1%, respectively. When linked and adjusted to hospitalization data, the risk for hip fracture was attenuated but remained overestimated for patients with RA. The predicted was 5.5% compared with 4.1% in whom fractures occurred. Adjustments for RA disease duration, high-dose glucocorticoid use and other factors did not improve the accuracy of the model for patients with RA. – by Shirley Pulawski
Disclosure s : The Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences employs Klop and has received unrestricted funding from the Netherlands Organization for Health Research and Development, the Dutch Health Care Insurance Board, the Royal Dutch Pharmacists Association, the private–public funded Top Institute Pharma, including co-funding from universities, government and industry, the EU Innovative Medicines Initiative, the EU 7th Framework Program, the Dutch Ministry of Health and industry (including GlaxoSmithKline, Pfizer and others). Please see the full study for a list of all other authors’ relevant financial disclosures.
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