N Guañabens1, J M Olmos2, J L Hernández2, D Cerdà3, C Hidalgo Calleja4, J A Martinez López5, L Arboleya6, F J Aguilar Del Rey7, S Martinez Pardo8, I Ros Vilamajó9, X Suris Armangué10, D Grados11, C Beltrán Audera12, E Suero-Rosario13, I Gómez Gracia14, A Salmoral Chamizo14, I Martín-Esteve13, H Florez15, A Naranjo16, S Castañeda17, S Ojeda Bruno16, S García Carazo18, A García Vadillo17, L López Vives19, À Martínez-Ferrer20, H Borrell Paños19, P Aguado Acín18, R Castellanos-Moreira15, C Tebé21, C Gómez-Vaquero22. 1. Department of Rheumatology, Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Barcelona, Spain. nguanabens@ub.edu. 2. Departament of Internal Medicine, University Hospital Marqués de Valdecilla-IDIVAL, Universidad de Cantabria, Santander, Spain. 3. Department of Rheumatology, Hospital Moisès Broggi, Sant Joan Despí, University of Barcelona, Barcelona, Spain. 4. Department of Rheumatology, University Hospital de Salamanca, Salamanca, Spain. 5. Department of Rheumatology, University Hospital Fundación Jiménez Díaz, Madrid, Spain. 6. Department of Rheumatology, University Hospital Central de Asturias, Oviedo, Spain. 7. Department of Rheumatology, University Hospital Virgen de la Victoria, Malaga, Spain. 8. Department of Rheumatology, University Hospital Mutua Terrassa, Barcelona, Spain. 9. Department of Rheumatology, Hospital Son Llàtzer, Palma de Mallorca, Spain. 10. Department of Rheumatology, Hospital General de Granollers, Granollers, International University of Catalunya, Barcelona, Spain. 11. Department of Rheumatology, Hospital d'Igualada, Igualada, Barcelona, Spain. 12. Department of Rheumatology, University Hospital Miguel Servet, Zaragoza, Spain. 13. Department of Rheumatology, Hospital General Mateu Orfila, Maó, Spain. 14. Department of Rheumatology, University Hospital Reina Sofía, Cordoba, Spain. 15. Department of Rheumatology, Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Barcelona, Spain. 16. Department of Rheumatology, University Hospital de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain. 17. Department of Rheumatology, University Hospital La Princesa IIS-IP, Madrid, Spain. 18. Department of Rheumatology, University Hospital La Paz, Madrid, Spain. 19. Department of Rheumatology, Hospital Sant Rafael, Barcelona, Spain. 20. Department of Rheumatology, University Hospital Doctor Peset, Valencia, Spain. 21. Biostatistics Unit, Bellvitge Biomedical Research Institute (IDIBELL) L'Hospitalet de Llobregat, Barcelona, Spain. 22. Department of Rheumatology, University Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
Abstract
Prevalence and risk factors of vertebral fractures in postmenopausal RA women were assessed in 323 patients and compared with 660 age-matched women. Of patients, 24.15% had at least one vertebral fracture vs.16.06% of controls. Age, glucocorticoids and falls were the main fracture risks. Vertebral fractures were associated with disease severity. INTRODUCTION: There is little quality data on the updated prevalence of fractures in rheumatoid arthritis (RA) that may have changed due to advances in the therapeutic strategy in recent years. This study was aimed at analysing the prevalence and risk factors of vertebral fractures in postmenopausal women with RA and comparing it with that of the general population. METHODS: We included 323 postmenopausal women diagnosed with RA from 19 Spanish Rheumatology Departments, randomly selected and recruited in 2018. Lateral radiographs of the thoracic and lumbar spine were obtained to evaluate morphometric vertebral fractures and the spinal deformity index. We analysed subject characteristics, factors related to RA, and fracture risk factors. The control group consisted of 660 age-matched Spanish postmenopausal women from the population-based Camargo cohort. RESULTS: Seventy-eight (24.15%) RA patients had at least one vertebral fracture. RA patients had increased fracture risk compared with controls (106 of 660, 16.06%) (p = 0.02). Logistic regression analysis showed that age (OR 2.17; 95% CI 1.27-4.00), glucocorticoids (OR 3.83; 95% CI 1.32-14.09) and falls (OR 3.57; 95% CI 1.91-6.86) were the independent predictors of vertebral fractures in RA patients. The subgroup with vertebral fractures had higher disease activity (DAS28: 3.15 vs. 2.78, p = 0.038) and disability (HAQ: 0.96 vs. 0.63, p = 0.049), as compared with those without vertebral fractures. CONCLUSION: The risk of vertebral fracture in RA is still high in recent years, when compared with the general population. The key determinants of fracture risk are age, glucocorticoids and falls. Patients with vertebral fractures have a more severe RA.
Prevalence and risk factors of vertebral fractures in postmenopausal RAwomen were assessed in 323 patients and compared with 660 age-matched women. Of patients, 24.15% had at least one vertebral fracture vs.16.06% of controls. Age, glucocorticoids and falls were the main fracture risks. Vertebral fractures were associated with disease severity. INTRODUCTION: There is little quality data on the updated prevalence of fractures in rheumatoid arthritis (RA) that may have changed due to advances in the therapeutic strategy in recent years. This study was aimed at analysing the prevalence and risk factors of vertebral fractures in postmenopausal women with RA and comparing it with that of the general population. METHODS: We included 323 postmenopausal women diagnosed with RA from 19 Spanish Rheumatology Departments, randomly selected and recruited in 2018. Lateral radiographs of the thoracic and lumbar spine were obtained to evaluate morphometric vertebral fractures and the spinal deformity index. We analysed subject characteristics, factors related to RA, and fracture risk factors. The control group consisted of 660 age-matched Spanish postmenopausal women from the population-based Camargo cohort. RESULTS: Seventy-eight (24.15%) RApatients had at least one vertebral fracture. RApatients had increased fracture risk compared with controls (106 of 660, 16.06%) (p = 0.02). Logistic regression analysis showed that age (OR 2.17; 95% CI 1.27-4.00), glucocorticoids (OR 3.83; 95% CI 1.32-14.09) and falls (OR 3.57; 95% CI 1.91-6.86) were the independent predictors of vertebral fractures in RApatients. The subgroup with vertebral fractures had higher disease activity (DAS28: 3.15 vs. 2.78, p = 0.038) and disability (HAQ: 0.96 vs. 0.63, p = 0.049), as compared with those without vertebral fractures. CONCLUSION: The risk of vertebral fracture in RA is still high in recent years, when compared with the general population. The key determinants of fracture risk are age, glucocorticoids and falls. Patients with vertebral fractures have a more severe RA.
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