SynthesisOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2018
Incidence of fractures among patients with rheumatoid arthritis: a systematic review and meta-analysis.
Synthesis in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
64 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Rheumatoid arthritis and subsequent fracture risk: an individual person meta-analysis to update FRAX.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Pooled it
- Ukrainian guideline for the prevention and treatment of glucocorticoid-induced osteoporosis.Archives of osteoporosis · 2025Guideline
- Frequency of osteoporosis in Chinese patients with rheumatoid arthritis: a meta-analysis.Archives of osteoporosis · 2023Pooled it
- The prevalence of osteoporosis in rheumatoid arthritis patient: a systematic review and meta-analysis.Scientific reports · 2022Pooled it
- Incidence and risk factors for vertebral fracture in rheumatoid arthritis: an update meta-analysis.Clinical rheumatology · 2022Pooled it
- Influence of Iguratimod on Bone Metabolism in Patients with Rheumatoid Arthritis: A Meta-analysis.International journal of clinical practice · 2022Pooled it
- Midlife risk factors predict long-term hip fracture risk in women: a 35-yr follow-up.JBMR plus · 2026Article
- High disease activity is associated with incident osteoporotic fractures among veterans with rheumatoid arthritis.Joint bone spine · 2026Article
- Osteoimmunology: Can We Prevent Bone Loss in Rheumatoid Arthritis with Modern Antirheumatic Drugs?Calcified tissue international · 2026Review
- Elucidating osteoporosis response signatures in rheumatoid arthritis using explainable machine learning ensembles.BMC musculoskeletal disorders · 2026Article
- Impact of immunosuppressive therapy and clinical risk factors on the prevalence of low bone mineral density in rheumatic diseases.Frontiers in medicine · 2026Article
- Impact of biologic and targeted synthetic therapies on bone health in immune-mediated inflammatory diseases: a narrative review.Frontiers in medicine · 2026Review
- Moderate-to-High 5-Year Cumulative Disease Activity and Lower Bone Mineral Density at the Proximal Femur are Major Predictors of Fragility Fractures in Women with Longstanding Rheumatoid Arthritis: An Observational Cohort Study.Calcified tissue international · 2025Observational
- Increasing fracture incidence over 13 years in patients with rheumatoid arthritis from the IORRA cohort.Journal of bone and mineral metabolism · 2025Observational
- [Decision-making process between plate osteosynthesis vs. endoprosthesis in proximal humerus fractures of the rheumatoid arthritis shoulder].Zeitschrift fur Rheumatologie · 2025Article
- Incidence of and Risk of Mortality After Hip Fractures in Rheumatoid Arthritis Relative to the General Population.Arthritis care & research · 2025Article
- Bone microarchitecture assessed by 3D high-resolution peripheral quantitative computed tomography (HR-pQCT) as predictor of fracture risk in patients with glucocorticoid-induced osteoporosis.Journal of orthopaedic translation · 2025Article
- Fracture-Related Safety Reporting of JAK Inhibitors: An Analysis from the WHO Global VigiBase.Drug safety · 2025Article
- Association of Immune-Mediated Inflammatory Diseases and Fracture Risk in Patients with Type 2 Diabetes: A Nationwide Population-Based Study.Journal of clinical medicine · 2025Article
- First fracture in rheumatoid arthritis: analysis by fracture site, gender, age, and comorbidities.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
4 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
This study is the first meta-analysis investigating the pooled incidence rates of fractures among patients with RA. Our results demonstrated that this population is at high risk of overall and fragility fractures. Consideration of vertebral imaging and RA-specific risk factor assessment may aid in fracture prevention for this vulnerable group.
introductionThis systematic review and meta-analysis aims to estimate the incidence of fractures (overall and fragility) in patients with rheumatoid arthritis (RA).
methodsMEDLINE, EMBASE, and CENTRAL were searched for cohort studies reporting incidence of fractures among patients with RA. Two reviewers independently assessed all studies for inclusion and extracted data. Pooled analyses of incidence rates and relative risk of fractures were conducted using a random-effects model. Subgroup analyses investigated potential sources of heterogeneity, and predictors of fractures were summarized.
resultsTwenty-five studies were included in total. The pooled incidence rates of overall and fragility fractures were 33.00 (95% CI 18.39-59.21) and 15.31 (95% CI 10.43-22.47) per 1000 person-years, respectively. Patients with RA had a higher risk of overall (RR 1.52, 95% CI 1.07-2.14) and fragility (RR 1.61, 95% CI 1.44-1.79) fractures. Subgroup analyses suggested a higher risk of fragility fractures among female patients (31.03 vs. 23.75 per 1000 person-years). The pooled site-specific incidence rates of vertebral, hip, forearm, and proximal humeral fractures were 7.51 (95% CI 3.27-17.23), 4.33 (95% CI 2.26-8.27), 3.40 (95% CI 2.27-5.10), and 1.86 (95% CI 1.36-2.53) per 1000 person-years, respectively. Clinical vertebral fractures were underestimated compared with radiographic screening (4.29 vs. 42.40 per 1000 person-years). Predictors of fractures included both traditional OP risk factors and RA-specific factors.
conclusionsPatients with RA are at high risk of incident overall and fragility fractures. Consideration of vertebral imaging for patients with additional OP risk factors, including RA-specific risk factors, may help with early OP diagnosis and timely intervention.
Indexed as
Identifiers
29546507What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.