Cited by 587Rheumatoid Arthritis Research and TherapiesBone health and osteoporosis researchMenopause: Health Impacts and Treatments

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Clinical assessment of the long-term risk of fracture in patients with rheumatoid arthritis.

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Staa, T. P. Van, Geusens, P., Bijlsma, J. W. J., Leufkens, H. G. M., Cooper, C.·2006·Arthritis & Rheumatism

DOI 10.1002/art.22117

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Abstract

Objective: To determine whether patients with rheumatoid arthritis (RA) have an increased risk of fracture, and to estimate their long‐term absolute fracture risk. Methods: We studied patients with RA ages ≥40 years in the British General Practice Research Database, each matched by age, sex, calendar time, and practice to 3 control patients. Incident fractures, as recorded in the computerized medical records, were ascertained over a median followup of 7.6 years. The fracture rate in RA patients compared with controls was adjusted for smoking, body mass index (BMI), and several clinical risk factors, and Cox proportional hazards models were used to calculate the relative risk (RR) of fracture in RA. A risk score was then developed to provide an estimate of the 5‐ and 10‐year fracture risk among RA patients. Results: There were 30,262 patients with RA, of whom 2,460 experienced a fracture during followup. Compared with controls, patients with RA had an increased risk of fracture, which was most marked at the hip (RR 2.0, 95% confidence interval [95% CI] 1.8–2.3) and spine (RR 2.4, 95% CI 2.0–2.8). Indicators of a substantially elevated risk of fracture (at the hip) included >10 years' duration of RA (RR 3.4, 95% CI 3.0–3.9), low BMI (RR 3.9, 95% CI 3.1–4.9), and use of oral glucocorticoids (RR 3.4, 95% CI 3.0–4.0). Modeling of the long‐term risk profiles revealed that, for example, in a woman age 65 years with longstanding RA whose risk factors also included low BMI, a history of fracture, and frequent use of oral glucocorticoids, the 5‐year risk of hip fracture was 5.7% (95% CI 5.3–6.1%). Conclusion: Patients with RA are at increased risk of osteoporotic fractures. This increased risk is attributable to a combination of disease activity and use of oral glucocorticoids.

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Arnett, F. C., Edworthy, S. M., Bloch, D. A., McShane, D. J., Fries, J. F., Cooper, N. S., Healey, L. A., Kaplan, S. R., Liang, M. H., Luthra, H. S., et al. (1988) · Arthritis & Rheumatism · doi:10.1002/art.1780310302 · Cited by 19,753
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van Staa, T. P., Leufkens, H. G. M., & Cooper, C. C. (2001) · Journal of Bone and Mineral Research · doi:10.1359/jbmr.2001.16.3.581 · Cited by 1,297
Self-citation
The epidemiology of corticosteroid-induced osteoporosis: a meta-analysis
Staa, T. P. V., Staa, T. P. V., Staa, T. P. V., Leufkens, H. G. M., & Cooper, C. (2002) · Osteoporosis International · doi:10.1007/s001980200108 · Cited by 1,294
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Use of oral corticosteroids and risk of fractures
Van Staa, T. P., Leufkens, H. G. M., Abenhaim, L., Zhang, B., & Cooper, C. (2000) · Journal of Bone and Mineral Research · doi:10.1359/jbmr.2000.15.6.993 · Cited by 1,263
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SH3BP2 Gain-Of-Function Mutation Exacerbates Inflammation and Bone Loss in a Murine Collagen-Induced Arthritis Model
Mukai, T., Gallant, R., Ishida, S., Yoshitaka, T., Kittaka, M., Nishida, K., Fox, D. A., Morita, Y., & Ueki, Y. (2014) · PLoS ONE · doi:10.1371/journal.pone.0105518 · Cited by 27
Predictors of bone density testing in patients with rheumatoid arthritis
Aizer, J., Reed, G. W., Onofrei, A., & Harrison, M. J. (2008) · Rheumatology International · doi:10.1007/s00296-008-0804-4 · Cited by 26
“Patients with RA remain at a higher risk of fracture than the general population, even without chronic glucocorticoid use [ 10 ].”
Background
Trends and Determinants of Osteoporosis Treatment and Screening in Patients With Rheumatoid Arthritis Compared to Osteoarthritis
Özen, G., Kamen, D. L., Mikuls, T. R., England, B. R., Wolfe, F., & Michaud, K. D. (2017) · Arthritis Care & Research · doi:10.1002/acr.23331 · Cited by 26
“Although it has been shown that higher BMI or weight was associated with a lower likelihood of developing osteoporotic fractures in RA patients (9,19), the limited data indicate no association between BMI and BMD testing (48).”
Background
Long-term fracture risk in rheumatoid arthritis: impact of early sustained DAS28-remission and restored function, progressive erosive disease, body mass index, autoantibody positivity and glucocorticoids. A cohort study over 10 years
Ajeganova, S., Andersson, M., Forslind, K., Gjertsson, I., Nyhäll-Wåhlin, B.-M., Svensson, B., & Hafström, I. (2023) · BMC Rheumatology · doi:10.1186/s41927-023-00347-6 · Cited by 25
“The prevalence of bone loss and the risk of osteoporosis-related fragility fractures (both vertebral and non-vertebral) is about double that expected in non-RA populations [6–8].”
Background
A customized protocol to assess bone quality in the metacarpal head, metacarpal shaft and distal radius: a high resolution peripheral quantitative computed tomography precision study
Feehan, L. M., Buie, H. R., LI, L. C., & McKay, H. A. (2013) · BMC Musculoskeletal Disorders · doi:10.1186/1471-2474-14-367 · Cited by 25
“Additionally, systemic extra-articular inflammatory bone changes contribute to a two-fold increase in fracture risk with aging in people living with RA [8-11].”
Background
Proton Pump Inhibitor Use and Risk of Hip Fracture in Kidney Transplant Recipients
Lenihan, C. R., Nair, S. S., Vangala, C., Ramanathan, V., Montez‐Rath, M. E., & Winkelmayer, W. C. (2016) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2016.09.019 · Cited by 25
Association between sarcopenia, physical performance and falls in patients with rheumatoid arthritis: a 1-year prospective study
Wiegmann, S., Armbrecht, G., Borucki, D., Buehring, B., Buttgereit, F., Detzer, C., Schaumburg, D., Zeiner, K. N., & Dietzel, R. (2021) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-021-04605-x · Cited by 25
“Due to an increased risk of fracture in patients with RA [20, 21] including a higher risk for hip fractures [21], the impact of rheumatoid arthritis-associated falls should not be underestimated and their risks should be identified early with a focus on prevention.”
Background
Data-driven identification of co-morbidities associated with rheumatoid arthritis in a large US health plan claims database
Petri, H., Maldonato, D., & Robinson, N. J. (2010) · BMC Musculoskeletal Disorders · doi:10.1186/1471-2474-11-247 · Cited by 25
“RR for osteoporosis is markedly increased, also for various fractures; this is in line with the findings of Van Staa et al based on the General Practice Research Database in the UK [ 24 ].”
Result
Cortical remodeling during menopause, rheumatoid arthritis, glucocorticoid and bisphosphonate therapy
Aeberli, D., & Schett, G. A. (2013) · Arthritis Research & Therapy · doi:10.1186/ar4180 · Cited by 25
The anti-osteoporosis effects of CSN1S2 protein of goat milk and yoghurt on a complete Freund's adjuvant-induced rheumatoid arthritis model in rats
Fatchiyah, F., Setiawan, B., Suharjono, S., & Noor, Z. (2015) · Biomarkers and Genomic Medicine · doi:10.1016/j.bgm.2015.10.001 · Cited by 25
Effects of long-term administration of pantoprazole on bone mineral density in young male rats
Matuszewska, A., Nowak, B., Rzeszutko, M., Zduniak, K., Szandruk-Bender, M., Jędrzejuk, D., Landwójtowicz, M., Bolanowski, M., Pieśniewska, M., Kwiatkowska, J., et al. (2016) · Pharmacological Reports · doi:10.1016/j.pharep.2016.06.012 · Cited by 25
“Osteoporotic fractures decrease patients’ quality of life, and may lead to disability and increased mortality rate [2].”
Evaluating osteoporotic fracture risk with the Fracture Risk Assessment Tool in Chinese patients with rheumatoid arthritis
Meng, J., Li, Y., Yuan, X., & Lu, Y. (2017) · Medicine · doi:10.1097/md.0000000000006677 · Cited by 25
Effects of Myricitrin and Relevant Molecular Mechanisms
Ma, R., Zhang, X., Zhang, K., & Wang, Y. (2018) · Current Stem Cell Research & Therapy · doi:10.2174/1574888x14666181126103338 · Cited by 29
Low-dose hydrocortisone replacement therapy is associated with improved bone remodelling balance in hypopituitary male patients
Behan, L.-A., Kelleher, G., Hannon, M. J., Brady, J. J., Rogers, B., Tormey, W., Smith, D., Thompson, C. J., McKenna, M. J., & Agha, A. (2014) · European Journal of Endocrinology · doi:10.1530/eje-13-0596 · Cited by 23
What evidence is there for a delay in diagnostic coding of RA in UK general practice records? An observational study of free text
Ford, E., Carroll, J., Smith, H., Davies, K., Koeling, R., Petersen, I., Rait, G., & Cassell, J. (2016) · BMJ Open · doi:10.1136/bmjopen-2015-010393 · Cited by 26
“Primary and secondary outcome measures: Assessment of (1) quantity and timing of text entries for disease-modifying antirheumatic drugs (DMARDs) as a proxy for the RA disease code, and (2) quantity, location and timing of free text information relating to RA onset and diagnosis.”
BackgroundMethod
Prevention of bone mineral density loss in patients with rheumatoid arthritis treated with anti-TNFα therapy
Miossec, P. (2008) · Biologics · doi:10.2147/btt.s2338 · Cited by 27
“…(Westhovens and Dequeker 2000; Green and Deodhar 2001; Sambrook et al 1987; Goldring and Gravallese 2000), as patients often have an increased risk of hip (Cooper et al 1995; Huusko et al 2001; van Staa et al 2006) or vertebral fractures (Spector et al 1993; Peel et al 1995; van Staa et al 2006).”
The limited effects of anti-tumor necrosis factor blockade on bone health in patients with rheumatoid arthritis under the use of glucocorticoid
Okano, T., Koike, T., Tada, M., Sugioka, Y., Mamoto, K., Wakitani, S., & Nakamura, H. (2013) · Journal of Bone and Mineral Metabolism · doi:10.1007/s00774-013-0535-9 · Cited by 24
Recent advances in rheumatoid arthritis
Suresh, E. (2010) · Postgraduate Medical Journal · doi:10.1136/pgmj.2009.090399 · Cited by 24
“Risk of fractures, especially of the hip, is increased.(84) The use of bisphosphonates for patients with RA is being explored, as they have the potential to prevent bone erosions through their effect on inhibiting osteoclastic bone resorption.”
Background
A GC polymorphism associated with serum 25-hydroxyvitamin D level is a risk factor for hip fracture in Japanese patients with rheumatoid arthritis: 10-year follow-up of the Institute of Rheumatology, Rheumatoid Arthritis cohort study
Yoshida, S., Ikari, K., Furuya, T., Toyama, Y., Taniguchi, A., Yamanaka, H., & Momohara, S. (2014) · Arthritis Research & Therapy · doi:10.1186/ar4516 · Cited by 24
“It is positively associated with muscle strength and physical performance, and is negatively associated with fall and fracture risk [8-11].”
Background
Anti-interleukin-6 receptor antibody prevents loss of bone structure and bone strength in collagen-induced arthritis mice
Yoshida, H., Suzuki, M., Tanaka, K., Takeda, S., Yogo, K., & Matsumoto, Y. (2018) · Scandinavian Journal of Rheumatology · doi:10.1080/03009742.2017.1416667 · Cited by 24
“Oral glucocorticoid treatment is thought to be the most common cause of systemic bone loss in RA patients (2–6); however, the relative risk of fracture in RA patients who have not taken oral glucocorticoids is also high (1).”
Background
Chronic arthritis directly induces quantitative and qualitative bone disturbances leading to compromised biomechanical properties.
Caetano‐Lopes, J., Nery, A., Henriques, R., Canhão, H. M., Duarte, J., Amaral, P. M., Vale, M., Moura, R. A., Pereira, P. A., Weinmann, P., et al. (2009) · PubMed · Cited by 24
Impact of Rheumatoid Arthritis and Its Management on Falls, Fracture and Bone Mineral Density in UK Biobank
Clynes, M. A., Jameson, K., Prieto‐Alhambra, D., Harvey, N. C., Cooper, C. C., & Dennison, E. M. (2019) · Frontiers in Endocrinology · doi:10.3389/fendo.2019.00817 · Cited by 23
“Furthermore, a study by van Staa and colleagues used data from the British General Practice Research Database to demonstrate that patients with RA have an increased risk of fractures at the hip, pelvis, vertebrae, humerus, and tibia/fibula (6).”
BackgroundMethodSelf-citation
Sites, frequencies, and causes of self-reported fractures in 9,720 rheumatoid arthritis patients: a large prospective observational cohort study in Japan
Ochi, K., Furuya, T., Ikari, K., Taniguchi, A., Yamanaka, H., & Momohara, S. (2013) · Archives of Osteoporosis · doi:10.1007/s11657-013-0130-7 · Cited by 23
Effects of romosozumab or denosumab treatment on the bone mineral density and disease activity for 6 months in patients with rheumatoid arthritis with severe osteoporosis: An open-label, randomized, pilot study
Mochizuki, T., Yano, K., Ikari, K., & Okazaki, K. (2021) · Osteoporosis and Sarcopenia · doi:10.1016/j.afos.2021.08.001 · Cited by 22
Risk factors associated with the occurrence of distal radius fractures in Japanese patients with rheumatoid arthritis: a prospective observational cohort study
Ochi, K., Go, Y., Furuya, T., Ikari, K., Taniguchi, A., Yamanaka, H., & Momohara, S. (2013) · Clinical Rheumatology · doi:10.1007/s10067-013-2415-z · Cited by 22
“This coincides well with previous reports from Japan, the USA, and Europe indicating that prednisolone is a risk factor for any fracture in patients with RA [1, 3, 5, 22, 23].”
Result
Identification of small molecule inhibitors of RANKL and TNF signalling as anti-inflammatory and antiresorptive agents in mice
Coste, E., Greig, I. R., Mollat, P., Rose, L., Gray, M., Ralston, S. H., & Hof, R. V. (2013) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2013-203700 · Cited by 22
Evaluating and mitigating fracture risk in established rheumatoid arthritis
Mullen, M. B., & Saag, K. G. (2015) · Best Practice & Research Clinical Rheumatology · doi:10.1016/j.berh.2015.09.005 · Cited by 23
“There was little evidence to correlate other measures of disease such as disease activity score (DAS), visual analogue scale (VAS), or acute phase reactants with increased fracture risk [1].”
Background
Risk of fragility fracture among patients with sarcoidosis: a population-based study 1976–2013
Ungprasert, P., Crowson, C. S., & Matteson, E. L. (2017) · Osteoporosis International · doi:10.1007/s00198-017-3962-y · Cited by 22
The Role of Autoantibodies in Bone Metabolism and Bone Loss
Hauser, B., & Harre, U. (2017) · Calcified Tissue International · doi:10.1007/s00223-017-0370-4 · Cited by 22
Increased risk of osteoporotic fractures in Swedish patients with rheumatoid arthritis despite early treatment with potent disease-modifying anti-rheumatic drugs: a prospective general population-matched cohort study
Nyhäll-Wåhlin, B.-M., Ajeganova, S., Petersson, I. F., & Andersson, M. (2019) · Scandinavian Journal of Rheumatology · doi:10.1080/03009742.2019.1611918 · Cited by 23
“A large epidemiological study (11) has shown that RA patients are at long-term increased risk of osteoporotic fractures.”
BackgroundResult
Rheumatoid arthritis in tight disease control is no longer risk of bone mineral density loss
Yoshii, I., Chijiwa, T., & Sawada, N. (2020) · Osteoporosis and Sarcopenia · doi:10.1016/j.afos.2020.04.002 · Cited by 22
“In summary, the potential factors contributing to these risk include: (1) increasing age and female sex as well as postmenopausal status [1e3,5,8,9,17,29e32], (2) higher disease activity [7,13,16,19,28,31e33], (3) high physical disability complicating ADLs or increased HAQ score [1e3,17,30,32,34], (4) long disease dur…”
BackgroundInfluential
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Tada, M., Yamada, Y., Mandai, K., & Hidaka, N. (2021) · Osteoporosis and Sarcopenia · doi:10.1016/j.afos.2021.06.002 · Cited by 21
Machine Learning Algorithms: Prediction and Feature Selection for Clinical Refracture after Surgically Treated Fragility Fracture
Shimizu, H., Enda, K., Shimizu, T., Ishida, Y., Ishizu, H., Ise, K., Tanaka, S., & Iwasaki, N. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11072021 · Cited by 19
“RA was also detected as a relevant feature for clinical refracture, and RA is known to be a risk factor for refracture as well as fracture [7,9].”
Background
The Effect of Anti-rheumatic Drugs on the Skeleton
Hauser, B., Raterman, H. G., Ralston, S. H., & Lems, W. F. (2022) · Calcified Tissue International · doi:10.1007/s00223-022-01001-y · Cited by 21
“Consequently, the fracture risk in patients with RA is at least double of that in the general population [5, 6].”
Background
Use of bisphosphonate might be important to improve bone mineral density in patients with rheumatoid arthritis even under tight control: the TOMORROW study
Tada, M., Inui, K., Sugioka, Y., Mamoto, K., Okano, T., Anno, S., & Koike, T. (2017) · Rheumatology International · doi:10.1007/s00296-017-3720-7 · Cited by 21
Proton Pump Inhibitors, Histamine-2 Receptor Antagonists, and Hip Fracture Risk among Patients on Hemodialysis
Vangala, C., Niu, J., Lenihan, C. R., Mitch, W. E., Navaneethan, S. D., & Winkelmayer, W. C. (2018) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.02190218 · Cited by 21
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Tada, M., Yamada, Y., Mandai, K., & Hidaka, N. (2020) · International Journal of Rheumatic Diseases · doi:10.1111/1756-185x.14033 · Cited by 21
Comparison of the efficacy of denosumab and bisphosphonates for treating secondary osteoporosis in patients with rheumatoid arthritis
Kinoshita, H., Miyakoshi, N., Kashiwagura, T., Kasukawa, Y., Sugimura, Y., & Shimada, Y. (2016) · Modern Rheumatology · doi:10.1080/14397595.2016.1232776 · Cited by 20
Evaluation des Trabecular Bone Score (TBS) in der täglichen Praxis bei Patienten mit entzündlich rheumatischen und nichtentzündlichen Erkrankungen
Buehring, B., Thomas, J. P., Wittkämper, T., Baraliakos, X., & Braun, J. (2020) · Zeitschrift für Rheumatologie · doi:10.1007/s00393-020-00764-9 · Cited by 19
Evaluation of Risk Factors for Falls in Patients with Rheumatoid Arthritis
Mikos, M., Kucharska, E., Lulek, A. M., Kłosiński, M., & Batko, B. P. (2020) · Medical Science Monitor · doi:10.12659/msm.921862 · Cited by 20
Pathogenic bone loss in rheumatoid arthritis: mechanisms and therapeutic approaches
Cantley, M. D., Smith, M., & Haynes, D. R. (2009) · International Journal of Clinical Rheumatology · doi:10.2217/ijr.09.42 · Cited by 20
There is still a care gap in osteoporosis management for patients with rheumatoid arthritis
Watt, J. A., Thompson, A., le Riche, N., & Pope, J. E. (2014) · Joint Bone Spine · doi:10.1016/j.jbspin.2014.02.001 · Cited by 19
Higher risk of hospitalized infection, cardiovascular disease, and fracture in patients with rheumatoid arthritis determined using the Japanese health insurance database
Kasai, S., Sakai, R., Koike, R., Kohsaka, H., Miyasaka, N., & Harigai, M. (2018) · Modern Rheumatology · doi:10.1080/14397595.2018.1519889 · Cited by 19
“general population [14,15] due to the high prevalence of”
Background
Effect of TNF inhibitors on bone mineral density in rheumatoid arthritis patients receiving bisphosphonate: a retrospective cohort study
Lee, J. S., Lim, D., Oh, J. S., Kim, Y., Lee, C., Yoo, B., & Hong, S. (2019) · Rheumatology International · doi:10.1007/s00296-019-04418-1 · Cited by 19
Effect of Single Versus Multiple Fractures on Systemic Bone Loss in Mice
Zhang, C., Zhu, J., Jia, J., Guan, Z., Sun, T., Zhang, W., Yuan, W., Wang, H., Leng, H., & Song, C. (2020) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.4211 · Cited by 19
“Patients with concurrent rheumatoid arthritis and a high IL-6 level were also reported to have an increased risk of osteoporotic fractures.((29)) In addition, early higher serum levels of IL-6 and TNF-αwere observed in an experimental polytrauma study and in patients with polytrauma, supporting the correlation between…”
Background
Infliximab prevents systemic bone loss and suppresses tendon inflammation in a collagen-induced arthritis rat model
Poutoglidou, F., Pourzitaki, C., Μanthou, M. E., Samoladas, E., Saitis, A., Malliou, F., & Kouvelas, D. (2021) · Inflammopharmacology · doi:10.1007/s10787-021-00815-w · Cited by 18
Cost-effectiveness of multifaceted evidence implementation programs for the prevention of glucocorticoid-induced osteoporosis
Beukelman, T., Saag, K. G., Curtis, J. R., Kilgore, M. L., & Pisu, M. (2009) · Osteoporosis International · doi:10.1007/s00198-009-1114-8 · Cited by 19
“Estimates of annual probability of fracture reflect current chronic glucocorticoid exposure [5, 6, 24, 26] and frequent concomitant rheumatic disease [25] among the hypothetical cohort [4].”
Background
Consenso 2012 da Sociedade Brasileira de Reumatologia sobre o manejo de comorbidades em pacientes com artrite reumatoide
Pereira, I. A., da Mota, L. M. H., Cruz, B. A., Brenol, C. V., Fronza, L. S. R., Bértolo, M. B., Freitas, M. V. C., da Silva, N. A., Louzada‐Júnior, P., Giorgi, R. D. N., et al. (2012) · Revista Brasileira de Reumatologia · doi:10.1590/s0482-50042012000400002 · Cited by 19
Increased risk of osteoporotic vertebral fracture in rheumatoid arthritis patients with new-onset cardiovascular diseases: a retrospective nationwide cohort study in Taiwan
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“Increased risks of osteoporosis (OP) or osteoporotic fractures have been reported in RA patients compared with healthy controls [4, 5].”
Background
Study of vertebral fracture and Scanographic Bone Attenuation Coefficient in rheumatoid arthritis and ankylosing spondylitis vs. controls
Fauny, M., Albuisson, É., Bauer, É., Perrier-Cornet, J., Chary-Valckenaere, I., & Lœuille, D. (2019) · Scientific Reports · doi:10.1038/s41598-019-49712-x · Cited by 19
A review of the use of dual-energy X-ray absorptiometry (DXA) in rheumatology
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Determining the Incidence of Adult Fractures: How Accurate Are Emergency Department Data?
Aitken, S. A., Rodrigues, M. A., Duckworth, A. D., Clement, N. D., McQueen, M. M., & Court-Brown, C. M. (2012) · Epidemiology Research International · doi:10.1155/2012/837928 · Cited by 19
Biomechanical effects of inflammatory diseases on bone-rheumatoid arthritis as a paradigm
Abdulghani, S., Caetano‐Lopes, J., Canhão, H. M., & Fonseca, J. E. (2009) · Autoimmunity Reviews · doi:10.1016/j.autrev.2009.02.021 · Cited by 18
Correlation between systemic osteoporosis and local bone erosion with rheumatoid arthritis patients in Chinese population
Gong, X., Xu, S., Tong, H., Wang, X., Zong, H.-X., Pan, M., Ten, Y.-Z., Xu, J., & Wei, W. (2019) · Lara D. Veeken · doi:10.1093/rheumatology/kez042 · Cited by 18
Osteoporosis evaluation and treatment recommendations in rheumatoid arthritis
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Risk factors associated with the occurrence of proximal humerus fractures in patients with rheumatoid arthritis: a custom strategy for preventing proximal humerus fractures
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Update on osteoporosis treatment
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The Risk of Osteoporotic Fractures According to the FRAX Model in Korean Patients with Rheumatoid Arthritis
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“Several case-control studies have documented a high rate of vertebral and hip fractures in patients with RA (2-4).”
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“Patients with rheumatoid arthritis have a higher risk of all types of fracture (99,101), whereas the risk of ankylosing spondylitis is specific to the vertebrae (100).”
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Vertebral fracture assessment: Current research status and application in patients with kyphoplasty
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Fragility Fractures Are Associated with an Increased Risk for Cardiovascular Events in Women and Men with Rheumatoid Arthritis: A Population-based Study
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Authors: Staa, T. P. V., Geusens, P., Bijlsma, J. W. J., Leufkens, H. G. M., & Cooper, C.
Affiliations: University of Southampton (GB)
University Medical Center Utrecht (NL)
Utrecht University (NL)
ORCID: Staa, T. P. Van
Geusens, P.
Bijlsma, J. W. J.
Leufkens, H. G. M.
Cooper, C.
Venue: Arthritis & Rheumatism
Publisher: Wiley
Published: 2006-09-28
Volume: 54
Issue: 10
Pages: 3104-3112
ISSN: 0004-3591 (ISSN-L)
1529-0131
DOI: 10.1002/art.22117
OpenAlex: W2098986981
Cited by: 587
References: 39
Citations by year: 2026: 8 · 2025: 15 · 2024: 19 · 2023: 21 · 2022: 26 · 2021: 56 · 2020: 44 · 2019: 37 · 2018: 50 · 2017: 40 · 2016: 32 · 2015: 30 · 2014: 34 · 2013: 33 · 2012: 38
FWCI: 11.88
Type: journal article
Language: en
Open access: green
dspace.library.uu.nl
Licence: other-oa
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Arthritis & Rheumatism (publishedVersion)
PubMed (publishedVersion)
Research Explorer (The University of Manchester) (publishedVersion)
Document Server@UHasselt (UHasselt) (submittedVersion)
Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
ePrints Soton (University of Southampton) (submittedVersion)
Topics: Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
Keywords: rheumatoid arthritis, fracture risk, osteoporotic fractures, hip fracture, spinal fractures, oral corticosteroids, body mass index, disease duration
MeSH terms: Adult, Aged, Aged, 80 and over, Algorithms, Arthritis, Rheumatoid, Female, Glucocorticoids, Humans, Male, Middle Aged, Osteoporosis, Risk Factors, Time Factors, Cohort Studies, Case-Control Studies, Fractures, Bone

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Clinical assessment of the long-term risk of fracture in patients with rheumatoid arthritis.

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