title: High incidence of vertebral and non-vertebral fractures in the OSTRA cohort study: a 5-year follow-up study in postmenopausal women with rheumatoid arthritis.
abstract: A 5-year follow-up study was performed in female RA patients with established disease looking at vertebral fractures, scored on spinal X-rays, and non-vertebral fractures. We found a high incidence rate of vertebral and non-vertebral fractures in these patients compared to population-based studies.
  
  
  BACKGROUND
  The aim of this study is to investigate the incidence of vertebral and non-vertebral fractures over a 5-year period in a cohort of postmenopausal patients with established rheumatoid arthritis (RA).
  
  
  METHODS
  One hundred and fifty female patients with established RA were included into the OSTRA cohort. The cohort was assessed at baseline and at 5 years for incident vertebral and non-vertebral fractures. Spinal X-rays were taken at baseline and at follow-up and scored using the semi-quantitative method according to Genant.
  
  
  RESULTS
  At 5 years, 102 patients (68%) were examined and included in the present analysis. At baseline, the mean age was 61 years, disease duration 17 years, body mass index 25.5 kg/m(2) and 65% of the patients were rheumatoid factor positive. Fifteen percent were treated with bisphosphonates, 25% received calcium supplementation and 20% vitamin-D supplementation at baseline. During the 5-year follow-up, a total of 16 patients out of 102 patients (16%) had a new non-vertebral fracture [annual incidence of 3.2 (95% CI 1.8-5.5) per 100 patients/year]. In 18 patients out of 97 patients (19%), new vertebral fractures were identified on spinal X-ray [annual incidence of 3.7 (95% C.I. 2.2-5.8) per 100 patients/year].
  
  
  CONCLUSIONS
  We found a high incidence of vertebral and non-vertebral fractures in a cohort of women with established RA compared to population-based studies.
authors.affiliation: Department of Rheumatology and Jan van Breemen Institute, VU University medical center, Postbus 7057, 1007MB, Amsterdam, The Netherlands. marijn.vis@gmail.com
authors.forename: M
authors.initials: M
authors.lastname: Vis
authors.forename: E A
authors.initials: EA
authors.lastname: Haavardsholm
authors.forename: P
authors.initials: P
authors.lastname: Bøyesen
authors.forename: G
authors.initials: G
authors.lastname: Haugeberg
authors.forename: T
authors.initials: T
authors.lastname: Uhlig
authors.forename: M
authors.initials: M
authors.lastname: Hoff
authors.forename: A
authors.initials: A
authors.lastname: Woolf
authors.forename: B
authors.initials: B
authors.lastname: Dijkmans
authors.forename: W
authors.initials: W
authors.lastname: Lems
authors.forename: T K
authors.initials: TK
authors.lastname: Kvien
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications; D015331:Cohort Studies; D004739:England / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009664:Norway / Q000453:epidemiology; D015663:Osteoporosis, Postmenopausal / Q000150:complications; D012307:Risk Factors; D016103:Spinal Fractures / Q000453:epidemiology* / Q000209:etiology