Vertebral fractures are increased in rheumatoid arthritis despite recent therapeutic advances: a case-control study
Por:
Guañabens N, Olmos JM, Hernández JL, Cerdà D, Hidalgo Calleja C, Martinez López JA, Arboleya L, Aguilar Del Rey FJ, Martinez Pardo S, Ros Vilamajó I, Suris Armangué X, Grados D, Beltrán Audera C, Suero-Rosario E, Gómez Gracia I, Salmoral Chamizo A, Martín-Esteve I, Florez H, Naranjo A, Castañeda S, Ojeda Bruno S, García Carazo S, García Vadillo A, López Vives L, Martínez-Ferrer À, Borrell Paños H, Aguado Acín P, Castellanos-Moreira R, Tebé C and Gómez-Vaquero C
Publicada:
1 jul 2021
Ahead of Print:
1 ene 2021
Resumen:
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.
Filiaciones:
Guañabens N:
Department of Rheumatology, Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Barcelona, Spain.
Olmos JM:
Departament of Internal Medicine, University Hospital Marqués de Valdecilla-IDIVAL, Universidad de Cantabria, Santander, Spain
Hernández JL:
Departament of Internal Medicine, University Hospital Marqués de Valdecilla-IDIVAL, Universidad de Cantabria, Santander, Spain
Cerdà D:
Department of Rheumatology, Hospital Moisès Broggi, Sant Joan Despí, University of Barcelona, Barcelona, Spain
Hidalgo Calleja C:
Department of Rheumatology, University Hospital de Salamanca, Salamanca, Spain
Martinez López JA:
Department of Rheumatology, University Hospital Fundación Jiménez Díaz, Madrid, Spain
Arboleya L:
Department of Rheumatology, University Hospital Central de Asturias, Oviedo, Spain
Aguilar Del Rey FJ:
Department of Rheumatology, University Hospital Virgen de la Victoria, Málaga, Spain
Martinez Pardo S:
Department of Rheumatology, University Hospital Mutua Terrassa, Barcelona, Spain
Ros Vilamajó I:
Department of Rheumatology, Hospital Son Llàtzer, Palma de Mallorca, Spain
Suris Armangué X:
Department of Rheumatology, Hospital General de Granollers, Granollers, International University of Catalunya, Barcelona, Spain
Grados D:
Department of Rheumatology, Hospital d'Igualada, Igualada, Barcelona, Spain
Beltrán Audera C:
Department of Rheumatology, University Hospital Miguel Servet, Zaragoza, Spain
Suero-Rosario E:
Department of Rheumatology, Hospital General Mateu Orfila, Maó, Spain
Gómez Gracia I:
Department of Rheumatology, University Hospital Reina Sofía, Córdoba, Spain
Salmoral Chamizo A:
Department of Rheumatology, University Hospital Reina Sofía, Córdoba, Spain
Martín-Esteve I:
Department of Rheumatology, Hospital General Mateu Orfila, Maó, Spain
Florez H:
Department of Rheumatology, Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Barcelona, Spain
Naranjo A:
Department of Rheumatology, University Hospital de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
Castañeda S:
Department of Rheumatology, University Hospital La Princesa IIS-IP, Madrid, Spain
Ojeda Bruno S:
Department of Rheumatology, University Hospital de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
García Carazo S:
Department of Rheumatology, University Hospital La Paz, Madrid, Spain
García Vadillo A:
Department of Rheumatology, University Hospital La Princesa IIS-IP, Madrid, Spain
López Vives L:
Department of Rheumatology, Hospital Sant Rafael, Barcelona, Spain
:
Department of Rheumatology, University Hospital Doctor Peset, Valencia, Spain
Borrell Paños H:
Department of Rheumatology, Hospital Sant Rafael, Barcelona, Spain
Aguado Acín P:
Department of Rheumatology, University Hospital La Paz, Madrid, Spain
Castellanos-Moreira R:
Department of Rheumatology, Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Barcelona, Spain
Tebé C:
Biostatistics Unit, Bellvitge Biomedical Research Institute (IDIBELL) L'Hospitalet de Llobregat, Barcelona, Spain
Gómez-Vaquero C:
Department of Rheumatology, University Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
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