Increasing fracture incidence over 13 years in patients with rheumatoid arthritis from the IORRA cohort.

IF 2.4 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of Bone and Mineral Metabolism Pub Date : 2025-04-07 DOI:10.1007/s00774-025-01598-8

Takefumi Furuya, Eisuke Inoue, Hisashi Yamanaka, Masayoshi Harigai, Eiichi Tanaka

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Abstract

Introduction: This study aimed to evaluate fracture incidence in patients with rheumatoid arthritis (RA) over 13 years in the Institute of Rheumatology Rheumatoid Arthritis (IORRA) cohort study.

Materials and methods: The IORRA is a prospective observational cohort study of Japanese patients with RA. Between 2011 and 2023, 10,257 patients with RA were enrolled. Clinical parameters and data on fractures were collected biannually using self-reported questionnaires. The fracture incidence, standardized by sex, age, and Japanese Health Assessment Questionnaire score, was calculated for each two-year period.

Results: From 2011 to 2023, the proportions of patients achieving Disease Activity Score in 28 joints remission, using biologic disease-modifying antirheumatic drugs, and taking osteoporosis medications increased (38.0% to 64.7%, 14.2% to 42.2%, and 31.6% to 38.3%, respectively), while the proportion of glucocorticoid use decreased (38.3% to 22.2%). The incidence of all and non-vertebral fractures increased from 47.2 and 36.7/1000 person-years in 2011 to 52.8 and 43.0/1000 person-years in 2023, respectively. Using 2023 as the reference, the standardized incidence ratios for all and non-vertebral fractures were: 2011-2012, 0.90 [95% confidence interval (CI) 0.82-0.98] and 0.86 (95% CI 0.78-0.95); 2013-2014, 0.88 (95% CI 0.81-0.96) and 0.84 (95% CI 0.76-0.93); 2015-2016, 0.94 (95% CI 0.86-1.02) and 0.89 (95% CI 0.80-0.98); 2017-2018, 0.97 (95% CI 0.88-1.07) and 0.94 (95% CI 0.84-1.05); 2019-2020, 0.95 (95% CI 0.84-1.07) and 0.93 (95% CI 0.81-1.06); 2021-2022, 1.00 (95% CI 0.89-1.13) and 0.99 (95% CI 0.86-1.13).

Conclusion: Despite advancements in RA management over 13 years, fracture incidence may have increased in patients with RA.

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IORRA队列中13年类风湿关节炎患者骨折发生率增加。

简介：本研究旨在评估类风湿关节炎研究所（IORRA） 13年来类风湿关节炎（RA）患者骨折发生率。材料和方法：IORRA是一项针对日本类风湿性关节炎患者的前瞻性观察队列研究。2011年至2023年间，10,257名RA患者入组。临床参数和骨折数据每半年通过自我报告问卷收集一次。骨折发生率按性别、年龄和日本健康评估问卷评分标准化，每两年计算一次。结果：2011 - 2023年，达到疾病活动度评分（Disease Activity Score）的患者在28个关节缓解期、使用生物减病抗风湿药物和服用骨质疏松药物的比例分别为38.0% - 64.7%、14.2% - 42.2%和31.6% - 38.3%，糖皮质激素的使用比例下降（38.3% - 22.2%）。全椎体骨折和非椎体骨折的发生率分别从2011年的47.2和36.7/1000人-年增加到2023年的52.8和40.3 /1000人-年。以2023年为参照，所有和非椎体骨折的标准化发生率分别为：2011-2012年，0.90[95%可信区间（CI） 0.82-0.98]和0.86 (95% CI 0.78-0.95)；2013-2014年分别为0.88 （95% CI 0.81-0.96）和0.84 (95% CI 0.76-0.93)；2015-2016年分别为0.94 （95% CI 0.86-1.02）和0.89 (95% CI 0.80-0.98)；2017-2018年，0.97 （95% CI 0.88-1.07）和0.94 (95% CI 0.84-1.05)；2019-2020年，0.95 （95% CI 0.84-1.07）和0.93 (95% CI 0.81-1.06)；2021-2022, 1.00 （95% CI 0.89-1.13）和0.99 （95% CI 0.86-1.13）。结论：尽管在过去的13年里，类风湿性关节炎的治疗取得了进展，但类风湿性关节炎患者骨折的发生率可能有所增加。

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来源期刊

Journal of Bone and Mineral Metabolism 医学-内分泌学与代谢

CiteScore

6.30

自引率

3.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal of Bone and Mineral Metabolism (JBMM) provides an international forum for researchers and clinicians to present and discuss topics relevant to bone, teeth, and mineral metabolism, as well as joint and musculoskeletal disorders. The journal welcomes the submission of manuscripts from any country. Membership in the society is not a prerequisite for submission. Acceptance is based on the originality, significance, and validity of the material presented. The journal is aimed at researchers and clinicians dedicated to improvements in research, development, and patient-care in the fields of bone and mineral metabolism.