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. 2011 Aug;38(8):1680-8.
doi: 10.3899/jrheum.101196. Epub 2011 May 15.

Arthritis increases the risk for fractures--results from the Women's Health Initiative

Nicole C Wright  1 , Jeffrey R Lisse, Brian T Walitt, Charles B Eaton, Zhao Chen; Women's Health Initiative Investigators
Collaborators, Affiliations

Arthritis increases the risk for fractures--results from the Women's Health Initiative

Nicole C Wright et al. J Rheumatol. 2011 Aug.

Abstract

Objective: To examine the relationship between arthritis and fracture.

Methods: Women were classified into 3 self-reported groups at baseline: no arthritis (n = 83,295), osteoarthritis (OA; n = 63,402), and rheumatoid arthritis (RA; n = 960). Incident fractures were self-reported throughout followup. Age-adjusted fracture rates by arthritis category were generated, and the Cox proportional hazards model was used to test the association between arthritis and fracture.

Results: After an average of 7.80 years, 24,137 total fractures were reported including 2559 self-reported clinical spinal fractures and 1698 adjudicated hip fractures. For each fracture type, age-adjusted fracture rates were highest in the RA group and lowest in the nonarthritic group. After adjustment for several covariates, report of arthritis was associated with increased risk for spine, hip, and any clinical fractures. Compared to the nonarthritis group, the risk of sustaining any clinical fracture in the OA group was HR 1.09 (95% CI 1.05, 1.13; p < 0.001) and HR 1.49 (95% CI 1.26, 1.75; p < 0.001) in the RA group. The risk of sustaining a hip fracture was not statistically increased in the OA group (HR 1.11; 95% CI 0.98, 1.25; p = 0.122) compared to the nonarthritis group; however, the risk of hip fracture increased significantly (HR 3.03; 95% CI 2.03, 4.51; p < 0.001) in the RA group compared to the nonarthritis group.

Conclusion: The increase in fracture risk confirms the importance of fracture prevention in patients with RA and OA.

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Figures

Figure 1
Figure 1
Age-Adjusted Fracture Rates by Arthritis Status Age-adjusted rates per 100 person-years and 95% confidence intervals (A) Any Fracture; (B) Spine; (C) Hip OA: Osteoarthritis RA: Rheumatoid arthritis
Figure 1
Figure 1
Age-Adjusted Fracture Rates by Arthritis Status Age-adjusted rates per 100 person-years and 95% confidence intervals (A) Any Fracture; (B) Spine; (C) Hip OA: Osteoarthritis RA: Rheumatoid arthritis
See this image and copyright information in PMC

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