Factors influencing fracture risk, T score, and management of osteoporosis in patients with rheumatoid arthritis in the Consortium of Rheumatology Researchers of North America (CORRONA) registry.
OBJECTIVE
This study examined a wide array of clinical factors to evaluate their influence on fracture risk and T scores in women with rheumatoid arthritis (RA) and determine if women with RA who are at risk for osteoporosis (OP) are adequately treated with OP medications.


METHODS
Data from 8419 female RA patients participating in the Consortium of Rheumatology Researchers of North America registry from March 02, 2006 to August 15, 2006 was evaluated. Covariates included medication subgroups, demographic, and clinical parameters. Lumbar spine and hip T scores and fracture rates were studied in relation to the variables. Use of OP medications in patients with OP risk factors was also evaluated.


RESULTS
Postmenopausal status and higher modified health assessment questionnaire score (mHAQ) had a negative effect on lumbar spine score,while marriage, education, and body mass index had a positive effect. A similar trend was found with hip T scores. Increase in overall fracture risk correlated with postmenopausal status, mHAQ, and prednisone use, while tumor necrosis factor monotherapy was associated with decreased overall fracture risk. mHAQ was also associated with nonhip/nonspine fractures. Eighty percent of patients had at least 1 risk factor for OP, but only 32% were on OP medications. Only 54% of patients with 3 risk factors were on OP medication.


CONCLUSIONS
In RA, postmenopausal status, mHAQ, and prednisone use were associated with a higher overall fracture risk. Women with RA who were at risk for OP may have been inadequately treated with OP medications.
Division of Rheumatology, Saint Louis University School of Medicine, Saint Louis, Missouri, USA. coulsonk@slu.edu
Kathryn A
KA
Coulson
George
G
Reed
Brooke E
BE
Gilliam
Joel M
JM
Kremer
Peri H
PH
Pepmueller
D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D015519:Bone Density / Q000502:physiology*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology* / Q000503:physiopathology*; D006306:Health Surveys; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D016015:Logistic Models; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control*; D017698:Postmenopause / Q000502:physiology; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use; D012042:Registries; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D000893:Anti-Inflammatory Agents; D050071:Bone Density Conservation Agents; D014409:Tumor Necrosis Factor-alpha; D011241:Prednisone