Rheumatoid arthritis is a risk factor for refracture in patients with fragility fractures

Abstract

Objectives: To determine whether patients with rheumatoid arthritis (RA) who have had fragility fractures are at an increased risk of refractures.

Methods: Patients with fragility fractures who were treated surgically at 10 hospitals from 2008 to 2017 and who underwent follow-up for >24 months were either categorized into a group comprising patients with RA or a group comprising patients without RA (controls). The groups were matched 1:1 by propensity score matching. Accordingly, 240 matched participants were included in this study. The primary outcome was the refracture rate in patients with RA as compared to in the controls. Multivariable analyses were also conducted on patients with RA to evaluate the odds ratios (ORs) for the refracture rates.

Results: Patients with RA were significantly associated with increased rates of refractures during the first 24 months (OR: 2.714, 95% confidence interval [95% CI]: 1.015-7.255; p = 0.040). Multivariable analyses revealed a significant association between increased refracture rates and long-term RA (OR: 6.308, 95% CI: 1.195-33.292; p = 0.030).

Conclusions: Patients with RA who have experienced fragility fractures are at an increased risk of refractures. Long-term RA is a substantial risk factor for refractures.

Keywords: Fragility fractures; propensity score matching; refractures; rheumatoid arthritis.