RT Journal Article
SR Electronic
T1 Are Young Women and Men with Rheumatoid Arthritis at Risk for Fragility Fractures? A Population-based Study
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.121493
DO 10.3899/jrheum.121493
A1 Shreyasee Amin
A1 Sherine E.  Gabriel
A1 Sara J.  Achenbach
A1 Elizabeth J.  Atkinson
A1 L. Joseph  Melton III
YR 2013
UL http://www.jrheum.org/content/early/2013/08/10/jrheum.121493.abstract
AB Objective Older women and men with rheumatoid arthritis (RA) are at increased risk for fractures, but limited information is available on fracture risk in younger individuals with RA and whether such risk occurs early in the disease onset or only when older. We determined the risk for fractures in both young and older women and men following RA diagnosis. Methods We studied a population-based inception cohort with RA from Olmsted County, Minnesota, USA. We identified 822 women and 349 men diagnosed with RA between 1955 and 2007 (308 women and 110 men diagnosed before age 50) and an equal number of paired non-RA subjects, matched by sex and birth year. Incident fractures were collected through review of complete (inpatient and outpatient) medical records available through the linkage system of the Rochester Epidemiology Project. Results The hazard ratio (HR; 95% CI) for a non-pathologic fracture occurring from no more than moderate trauma was 1.63 (1.36–1.96) for women and 1.40 (1.02–1.93) for men with RA. Findings were consistent for women and men diagnosed with RA at age ≥ 50 years [HR, 1.43 (1.16–1.77) and 1.34 (0.92–1.94), respectively], or at age < 50 years [HR, 2.34 (1.61–3.42) and 1.74 (0.91–3.30), respectively]. However, young women, but not young men, with RA were at increased fracture risk even before age 50 years (HR, 1.95 [1.08–3.51] and 0.82 [0.28–2.45], respectively). Conclusion Young men with RA are at increased risk for fractures only when older, whereas young women with RA have an elevated fracture risk even while still young.