TY - JOUR T1 - The risk and consequences of vertebral fracture in patients with Ankylosing Spondylitis: a population-based data linkage study JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.190675 SP - jrheum.190675 AU - Milica Ognjenovic AU - Warren Raymond AU - Charles Inderjeeth AU - Helen Keen AU - David Preen AU - Johannes Nossent Y1 - 2020/02/15 UR - http://www.jrheum.org/content/early/2020/02/10/jrheum.190675.abstract N2 - Objective To compare the long-term prevalence, incidence and outcomes of vertebral fracture (VF) between ankylosing spondylitis (AS) patients and matched controls, including the role of extra-articular manifestations (EAM) and osteoporosis. Methods State-wide observational study using linked health data for 2,321 AS patients and 22,976 controls presenting to hospital from 1980-2015. Data were analysed using incidence rates (per 1000 person-years) and ratios (IRR), multivariable Cox-proportional hazard regression and Kaplan-Meier survival curves. Results Over a median 13.92 (IQR 7.58, 21.67) years of follow-up, AS patients had a greater VF prevalence and incidence of developing a new VF compared to controls (9.3% vs 2.5%, 6.8% vs 1.9%, respectively, all p<0.001). AS patients had an increased risk of developing a VF after adjustment for age, sex and osteoporosis (HR=2.55; 95%CI: 2.11, 3.09) compared to controls, and remained throughout the study period. AS patients were 5-years younger at time of first VF (p=0.008) and had a greater likelihood of a re-current VF (IRR=4.64; 95%CI: 4.54, 4.75) compared to respective controls. Mortality overall was comparable between AS patients and controls after adjustment for age, sex, osteoporosis and VF status (HR=0.90; 95%CI: 0.80, 1.01). Conclusion The significantly increased risk for VF in AS patients has not altered following the introduction of TNFi treatment. While AS patients experience a first VF at a younger age than controls, this does not lead to an increased risk of death. ER -