Fractures in rheumatoid arthritis: an evaluation of associated risk factors.
OBJECTIVE
Our purpose was to identify factors indicative of a high fracture risk during the disease course of rheumatoid arthritis (RA).


METHODS
In 1110 patients (879 women and 231 men) with RA from five Arthritis, Rheumatism and Aging Medical Information System centers, information from history, clinical and laboratory examination, outcome assessment, and therapy was evaluated for association with the 226 first fractures having occurred during the years from 1975 to 1988.


RESULTS
The mean age of the patients was 54 years, the mean time of observation was 8 years. Multivariate analyses identified the following factors to be associated with fracturing: years taking prednisone, previous diagnosis of osteoporosis, disability, age, lack of physical activity, female sex, disease duration, impaired grip strength, and low body mass.


CONCLUSIONS
We conclude that patients with RA at greatest risk for fracturing are easily identified by using a few clinical variables. These findings support encouragement of active lifestyle habits and avoidance of longterm administration of corticosteroids in patients with RA.
Michel
B A
BA
Department of Rheumatology, University Hospital, Zurich, Switzerland.
Bloch
D A
DA
Wolfe
F
F
Fries
J F
JF
D000375:Aging / Q000502:physiology; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D015992:Body Mass Index; D006233:Persons with Disabilities; D005260:Female; D050723:Fractures, Bone / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010024:Osteoporosis / Q000150:complications; D011241:Prednisone / Q000627:therapeutic use; D012307:Risk Factors; D012727:Sex Characteristics; D013997:Time Factors
D011241:Prednisone