Rheumatoid arthritis, corticosteroid therapy and hip fracture.
OBJECTIVE
To identify the risk of hip fracture in patients with rheumatoid arthritis and those taking corticosteroids.


METHODS
In a population based case-control study, we compared 300 consecutive patients with hip fracture aged 50 years and over from a defined district and 600 age and sex matched community controls.


RESULTS
The risk of hip fracture was increased in patients with rheumatoid arthritis (odds ratio (OR) 2.1; 95% confidence interval (CI) 1.0 to 4.7) and those receiving corticosteroids (OR 2.7; 95% CI 1.2 to 5.8). The risk attributable to rheumatoid arthritis was markedly reduced by adjusting for functional impairment, while that for steroid use remained after adjusting for body mass index, smoking, alcohol, and functional status.


CONCLUSIONS
Hip fracture risk is approximately doubled amongst patients with rheumatoid arthritis and among those taking steroids. These risk increases are, to some extent, independent of each other. In rheumatoid arthritis, the risk was most closely associated with functional impairment, whereas steroid use did not appear to be confounded by this variable.
Cooper
C
C
MRC Environmental Epidemiology Unit, Southampton General Hospital, United Kingdom.
Coupland
C
C
Mitchell
M
M
D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000503:physiopathology; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006620:Hip Fractures / Q000139:chemically induced / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
D005938:Glucocorticoids