ArticleArthritis & rheumatology (Hoboken, N.J.)2025
Association of Therapies for Axial Spondyloarthritis on the Risk of Hip and Spine Fractures.
Article in Arthritis & rheumatology (Hoboken, N.J.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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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.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Disease-modifying anti-rheumatic drugs and systemic glucocorticoid use and risk of vertebral fractures in axial spondyloarthropathies: a systematic review and meta-analysis.Clinical rheumatology · 2026Pooled it
- Fragility Score in Radiographic Axial Spondyloarthritis Assessed with Radiofrequency Echographic Multi-Spectrometry (REMS).Life (Basel, Switzerland) · 2026Article
- Patient Diagnostic Journey and Time to Diagnosis in Axial Spondyloarthritis: A Retrospective Cohort Study Using US Claims Data.Rheumatology and therapy · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectivePeople with axial spondyloarthritis (axSpA) have increased fracture risk relative to the general population, possibly related to chronic inflammation. We assessed the impact of treatment with receiving tumor necrosis factor inhibitors (TNFis) and nonbiologic conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) on hip and spine fractures in patients with axSpA, relative to receiving nonsteroidal anti-inflammatory drugs (NSAIDs).
methodsWe conducted a nested case-control study using 2006 to 2021 data from the Merative MarketScan Database. We included adults 18 to 65 years old with at least one inpatient or at least two outpatient axSpA International Classification of Diseases, Ninth Revision (ICD-9), or International Classification of Diseases, Tenth Revision (ICD-10), diagnosis codes separated by at least seven days. The primary outcome was hip and/or spine fracture, defined by ICD-9 or ICD-10 diagnosis or procedure codes. For each patient with fracture (cases), we selected up to 10 controls without fracture. We evaluated medication exposure (TNFis, csDMARDs, NSAIDs [referent], or none) hierarchically using pharmacy claims and procedure codes. We assessed the relation of medication exposure with hip and spine fracture risk using unconditional logistic regression with confounder adjustment.
resultsOur main analysis included 13,519 individuals with axSpA, comprising 1,229 patients with fracture and 12,290 controls. Individuals receiving TNFis had 29% lower odds of fracture compared to those receiving NSAIDs (odds ratio [OR] 0.71, 95% confidence interval [CI] 0.59-0.85), accounting for age, sex, and diagnosis year. Results were similar in the fully adjusted model (OR 0.75, 95% CI 0.62-0.91) and when stratified by sex.
conclusionUsing a large US insurance claims database, we found evidence for a protective effect of receiving TNFis on fracture risk in patients with axSpA underscoring a potential impact of TNFis in diminishing comorbidities linked with axSpA.
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