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

The DOI matches its Crossref record; 39 of the 39 references it cites were found in a registry or an index.

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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Crossref · 10.1002/art.22117

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Metadata

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
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
Licence
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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