Risk factor analysis of fragility fractures in rheumatoid arthritis: A 3-year longitudinal, real-world, observational, cohort study.

Risk factor analysis of fragility fractures in rheumatoid arthritis: A 3-year longitudinal, real-world, observational, cohort study.

<h4>Objectives</h4>To explore the risk factors for fragility fractures in rheumatoid arthritis (RA) patients using a 3-year longitudinal, observational cohort study.<h4>Methods</h4>This RA registry study included consecutive RA patients in the outpatient clinic of Chang Gung...

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Autores principales: Po-Heng Lin, Shan-Fu Yu, Jia-Feng Chen, Ying-Chou Chen, Han-Ming Lai, Wen-Chan Chiu, Chung-Yuan Hsu, Yu-Wei Wang, Hsiao-Ru He, You-Yin Chen, Chu-Yin Cheng, Tien-Tsai Cheng
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Lenguaje:EN
Publicado: Public Library of Science (PLoS) 2021
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Science
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Acceso en línea:https://doaj.org/article/bb34e33dbac04607b222e90e2abf5655
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spelling oai:doaj.org-article:bb34e33dbac04607b222e90e2abf56552021-12-02T20:18:43ZRisk factor analysis of fragility fractures in rheumatoid arthritis: A 3-year longitudinal, real-world, observational, cohort study.1932-620310.1371/journal.pone.0255542https://doaj.org/article/bb34e33dbac04607b222e90e2abf56552021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0255542https://doaj.org/toc/1932-6203<h4>Objectives</h4>To explore the risk factors for fragility fractures in rheumatoid arthritis (RA) patients using a 3-year longitudinal, observational cohort study.<h4>Methods</h4>This RA registry study included consecutive RA patients in the outpatient clinic of Chang Gung Memorial Hospital since September 1, 2014. The demographics, clinical characteristics, lifestyle, evidence of previous fracture, risk factors according to the Fracture Risk Assessment Tool (FRAX®), and the FRAX score of each participant were recorded. The participants were categorized into the new incident fracture (group A) and no incident fracture (group B) groups based on evidence or absence of new incident fractures and propensity score matching (age and gender, 1:2).<h4>Results</h4>Overall, 477 participants completed the 3-year observation period. After matching, 103 and 206 participants were allocated to groups A and B, respectively. The non-adjusted model revealed, presented as hazard ratio (HR) (95% confidence interval [CI]), that the presence of co-morbidity (1.80 [1.17-2.78], p = 0.008), Health Assessment Questionnaire Disability Index (1.35 [1.07-1.69], p = 0.010), lower baseline hip bone mineral density (0.11 [0.02-0.48], p = 0.004), longer disease duration (1.02 [1.00-1.04], p = 0.026), higher FRAX score of major fracture (1.03 [1.02-1.04], p<0.001) or hip fracture (1.03 [1.02-1.04], p<0.001), and previous fracture history (2.65 [1.79-3.94], p<0.001) were associated with new incident fracture. After adjustment, it was disclosed that a previous fracture is an independent risk factor for fragility fractures in RA patients (2.17 [1.20-3.90], p = 0.010).<h4>Conclusions</h4>In addition to aging and disease-related factors, previous fracture history is the most important risk factor for fragility fractures in RA patients.Po-Heng LinShan-Fu YuJia-Feng ChenYing-Chou ChenHan-Ming LaiWen-Chan ChiuChung-Yuan HsuYu-Wei WangHsiao-Ru HeYou-Yin ChenChu-Yin ChengTien-Tsai ChengPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0255542 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Po-Heng Lin
Shan-Fu Yu
Jia-Feng Chen
Ying-Chou Chen
Han-Ming Lai
Wen-Chan Chiu
Chung-Yuan Hsu
Yu-Wei Wang
Hsiao-Ru He
You-Yin Chen
Chu-Yin Cheng
Tien-Tsai Cheng
Risk factor analysis of fragility fractures in rheumatoid arthritis: A 3-year longitudinal, real-world, observational, cohort study.
description <h4>Objectives</h4>To explore the risk factors for fragility fractures in rheumatoid arthritis (RA) patients using a 3-year longitudinal, observational cohort study.<h4>Methods</h4>This RA registry study included consecutive RA patients in the outpatient clinic of Chang Gung Memorial Hospital since September 1, 2014. The demographics, clinical characteristics, lifestyle, evidence of previous fracture, risk factors according to the Fracture Risk Assessment Tool (FRAX®), and the FRAX score of each participant were recorded. The participants were categorized into the new incident fracture (group A) and no incident fracture (group B) groups based on evidence or absence of new incident fractures and propensity score matching (age and gender, 1:2).<h4>Results</h4>Overall, 477 participants completed the 3-year observation period. After matching, 103 and 206 participants were allocated to groups A and B, respectively. The non-adjusted model revealed, presented as hazard ratio (HR) (95% confidence interval [CI]), that the presence of co-morbidity (1.80 [1.17-2.78], p = 0.008), Health Assessment Questionnaire Disability Index (1.35 [1.07-1.69], p = 0.010), lower baseline hip bone mineral density (0.11 [0.02-0.48], p = 0.004), longer disease duration (1.02 [1.00-1.04], p = 0.026), higher FRAX score of major fracture (1.03 [1.02-1.04], p<0.001) or hip fracture (1.03 [1.02-1.04], p<0.001), and previous fracture history (2.65 [1.79-3.94], p<0.001) were associated with new incident fracture. After adjustment, it was disclosed that a previous fracture is an independent risk factor for fragility fractures in RA patients (2.17 [1.20-3.90], p = 0.010).<h4>Conclusions</h4>In addition to aging and disease-related factors, previous fracture history is the most important risk factor for fragility fractures in RA patients.
format article
author Po-Heng Lin
Shan-Fu Yu
Jia-Feng Chen
Ying-Chou Chen
Han-Ming Lai
Wen-Chan Chiu
Chung-Yuan Hsu
Yu-Wei Wang
Hsiao-Ru He
You-Yin Chen
Chu-Yin Cheng
Tien-Tsai Cheng
author_facet Po-Heng Lin
Shan-Fu Yu
Jia-Feng Chen
Ying-Chou Chen
Han-Ming Lai
Wen-Chan Chiu
Chung-Yuan Hsu
Yu-Wei Wang
Hsiao-Ru He
You-Yin Chen
Chu-Yin Cheng
Tien-Tsai Cheng
author_sort Po-Heng Lin
title Risk factor analysis of fragility fractures in rheumatoid arthritis: A 3-year longitudinal, real-world, observational, cohort study.
title_short Risk factor analysis of fragility fractures in rheumatoid arthritis: A 3-year longitudinal, real-world, observational, cohort study.
title_full Risk factor analysis of fragility fractures in rheumatoid arthritis: A 3-year longitudinal, real-world, observational, cohort study.
title_fullStr Risk factor analysis of fragility fractures in rheumatoid arthritis: A 3-year longitudinal, real-world, observational, cohort study.
title_full_unstemmed Risk factor analysis of fragility fractures in rheumatoid arthritis: A 3-year longitudinal, real-world, observational, cohort study.
title_sort risk factor analysis of fragility fractures in rheumatoid arthritis: a 3-year longitudinal, real-world, observational, cohort study.
publisher Public Library of Science (PLoS)
publishDate 2021
url https://doaj.org/article/bb34e33dbac04607b222e90e2abf5655
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