Evidence map›Paper›PMID 39532717›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2025

First fracture in rheumatoid arthritis: analysis by fracture site, gender, age, and comorbidities.

Owen Taylor-Williams, Helen Keen, David B Preen, Johannes Nossent, Charles A Inderjeeth

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Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

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0cells of the map it votes in
4citing papers in PubMed
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1 · What the graph read from 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.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Osteoporosis in rheumatoid arthritis: a new perspective on risk factors and clinical prediction models.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Owen Taylor-WilliamsRheumatology Group, Medical School, University of Western Australia, Perth, Australia. Owen.Taylor-Williams@research.uwa.edu.au.ORCID http://orcid.org/0000-0001-7021-7588
Helen KeenDepartment Rheumatology, Sir Charles Gairdner Hospital, Perth, Australia.
David B PreenSchool of Population and Global Health, University of Western Australia, Perth, Australia.
Johannes NossentRheumatology Group, Medical School, University of Western Australia, Perth, Australia.
Charles A InderjeethRheumatology Group, Medical School, University of Western Australia, Perth, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Rheumatoid arthritis (RA) is a potentially devastating disorder associated with increased risk of fractures, but current studies do not completely evaluate the RA fracture risk profile. This study estimates fracture incidence by site of fracture and makes comparisons between RA and controls using the key variables gender, age, and comorbidities.

backgroundRheumatoid arthritis RA is a potentially devastating osteoimmunological disorder, predisposing to osteoporosis (OP), fragility fracture (FF), and major osteoporotic fractures (MOF). As few studies incorporate statistical matching, comorbidity and non-MOF sites, we compared the incidence of first FF, MOF, and non-MOF in RA patients with a matched control cohort adjusting for comorbidities.

methodsThis longitudinal cohort study uses routinely collected administrative data from the West Australian Rheumatic Disease Epidemiological Registry (WARDER) between 1980 and 2015. RA patients, as defined using International Classification of Disease (ICD) codes, were compared to hospitalised patients free of rheumatic disease. Case-control matching adjusted for age, gender, and comorbidities (Charlson Comorbidity Index). Incidence rates (IR) per 1000 person years (PY) with 95% confidence intervals (CI) were compared by incidence rate ratios (IRR).

findingsIn RA patients from 2000 to 2010, the first fracture IR was 18.3 (15.7-21.2) for an IRR of 1.32 (1.10-1.60). Upper limb, lower limb, and axial IR were 5.56 (95% CI 4.18-7.26), 10.60 (95% CI 8.66-12.87), and 2.47 (95% CI 2.58-3.68) with IRR of 1.18 (95% CI 0.84-1.65), 1.44 (95% CI 1.19-1.86), and 1.01 (95% CI 0.61-1.63) respectively. The first fracture IR increased 6 years before first RA hospital record (RR 1.58, CI 1.05-2.39).

conclusionsAfter age, gender, and comorbidity adjustment, RA is associated with a 32% higher incidence of first fracture, increased MOF, and a fracture incidence that is already increased before a first recorded RA diagnosis. This suggests a need for early attention to prevention of all fractures in RA patients.

Indexed as

Arthritis, RheumatoidComorbidityOsteoporotic FracturesAdultAgedAged, 80 and overAge DistributionCase-Control StudiesFemaleHip FracturesHumansIncidenceLongitudinal StudiesMaleMiddle AgedRegistriesAutoimmune conditionFirst fractureRheumatoid arthritis

Identifiers

PMID39532717

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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.