Increased fracture risk in patients with rheumatic disorders and other inflammatory diseases -- a case-control study with 53,108 patients with fracture.
OBJECTIVE
To identify the risk of hip and vertebral fractures in patients with rheumatic disorders (RD) and inflammatory bowel diseases (IBD).


METHODS
This population-based case-control study assessed the fracture risk of patients with rheumatoid arthritis, juvenile idiopathic arthritis (JIA), ankylosing spondylitis (AS), systemic lupus erythematosus, polymyositis/dermatomyositis (PM/DM), systemic sclerosis (SSc), Crohn's disease, and ulcerative colitis (UC). The study cohort comprised 53,108 patients with fracture (66% women) and 370,602 age-matched and sex-matched controls. Conditional logistic regression analysis was performed and results were expressed as OR with corresponding 95% CI.


RESULTS
There was a statistically significant increased fracture risk for all RD and for IBD compared with controls. The magnitude of fracture risk was higher for patients with RD (OR 3, 95% CI 2.9-3.2) than for those with IBD (OR 1.6, 1.4-1.8). The OR in RD ranged from 2.6 (1.3-4.9) for SSc to 4 (3.4-4.6) for AS. The largest increased fracture risk for vertebral fractures was seen in AS (OR 7.1, 6-8.4) and for hip fractures in JIA (OR 4.1, 2.4-6.9).


CONCLUSIONS
Our results highlight the existence of an increased fracture risk from a variety of underlying causes in patients with RD and IBD. In many inflammatory diseases, implementation of fracture prevention strategies may be beneficial.
Weiss
Rüdiger J
RJ
Department of Molecular Medicine and Surgery, Section of Orthopedics and Sports Medicine, Karolinska University Hospital/Karolinska Institutet, S-171 76, Stockholm, Sweden. rudiger.weiss@karolinska.se
Wick
Marius C
MC
Ackermann
Paul W
PW
Montgomery
Scott M
SM
D000368:Aged; D016022:Case-Control Studies; D005260:Female; D050723:Fractures, Bone / Q000209:etiology*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012216:Rheumatic Diseases / Q000150:complications*; D012306:Risk