Arthritis increases the risk for fractures - Results from the women's health initiative

Nicole C. Wright; Jeffrey R. Lisse; Brian T. Walitt; Charles B. Eaton; Zhao Chen; Elizabeth Nabel; Jacques Rossouw; Shari Ludlam; Linda Pottern; Joan McGowan; Leslie Ford; Nancy Geller; Ross Prentice; Garnet Anderson; Andrea LaCroix; Charles L. Kooperberg; Ruth E. Patterson; Anne McTiernan; Sally Shumaker; Evan Stein; Steven Cummings; Sylvia Wassertheil-Smoller; Aleksandar Rajkovic; Jo Ann Manson; Annlouise R. Assaf; Lawrence Phillips; Shirley Beresford; Judith Hsia; Rowan Chlebowski; Evelyn Whitlock; Bette Caan; Jane Morley Kotchen; Barbara V. Howard; Linda Van Horn; Henry Black; Marcia L. Stefanick; Dorothy Lane; Rebecca Jackson; Cora E. Lewis; Tamsen Bassford; Jean Wactawski-Wende; John Robbins; F. Allan Hubbell; Lauren Nathan; Robert D. Langer; Margery Gass; Marian Limacher; David Curb; Robert Wallace; Judith Ockene; Norman Lasser; Mary Jo O'Sullivan; Karen Margolis; Robert Brunner; Gerardo Heiss; Lewis Kuller; Karen C. Johnson; Robert Brzyski; Gloria E. Sarto; Mara Vitolins; Susan Hendrix

doi:10.3899/jrheum.101196

Arthritis increases the risk for fractures - Results from the women's health initiative

Nicole C. Wright, Jeffrey R. Lisse, Brian T. Walitt, Charles B. Eaton, Zhao Chen, Elizabeth Nabel, Jacques Rossouw, Shari Ludlam, Linda Pottern, Joan McGowan, Leslie Ford, Nancy Geller, Ross Prentice, Garnet Anderson, Andrea LaCroix, Charles L. Kooperberg, Ruth E. Patterson, Anne McTiernan, Sally Shumaker, Evan SteinSteven Cummings, Sylvia Wassertheil-Smoller, Aleksandar Rajkovic, Jo Ann Manson, Annlouise R. Assaf, Lawrence Phillips, Shirley Beresford, Judith Hsia, Rowan Chlebowski, Evelyn Whitlock, Bette Caan, Jane Morley Kotchen, Barbara V. Howard, Linda Van Horn, Henry Black, Marcia L. Stefanick, Dorothy Lane, Rebecca Jackson, Cora E. Lewis, Tamsen Bassford, Jean Wactawski-Wende, John Robbins, F. Allan Hubbell, Lauren Nathan, Robert D. Langer, Margery Gass, Marian Limacher, David Curb, Robert Wallace, Judith Ockene, Norman Lasser, Mary Jo O'Sullivan, Karen Margolis, Robert Brunner, Gerardo Heiss, Lewis Kuller, Karen C. Johnson, Robert Brzyski, Gloria E. Sarto, Mara Vitolins, Susan Hendrix

Research output: Contribution to journal › Article › peer-review

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Abstract

Objective. To examine the relationship between arthritis and fracture. Methods. Women were classified into 3 self-reported groups at baseline: no arthritis (n = 83,295), osteoarthritis (OA; n = 63,402), and rheumatoid arthritis (RA; n = 960). Incident fractures were self-reported throughout followup. Age-adjusted fracture rates by arthritis category were generated, and the Cox proportional hazards model was used to test the association between arthritis and fracture. Results. After an average of 7.80 years, 24,137 total fractures were reported including 2559 self-reported clinical spinal fractures and 1698 adjudicated hip fractures. For each fracture type, age-adjusted fracture rates were highest in the RA group and lowest in the nonarthritic group. After adjustment for several covariates, report of arthritis was associated with increased risk for spine, hip, and any clinical fractures. Compared to the nonarthritis group, the risk of sustaining any clinical fracture in the OA group was HR 1.09 (95% CI 1.05, 1.13; p < 0.001) and HR 1.49 (95% CI 1.26, 1.75; p < 0.001) in the RA group. The risk of sustaining a hip fracture was not statistically increased in the OA group (HR 1.11; 95% CI 0.98, 1.25; p = 0.122) compared to the nonarthritis group; however, the risk of hip fracture increased significantly (HR 3.03; 95% CI 2.03, 4.51; p < 0.001) in the RA group compared to the nonarthritis group. Conclusion. The increase in fracture risk confirms the importance of fracture prevention in patients with RA and OA. The Journal of Rheumatology

Original language	English (US)
Pages (from-to)	1680-1688
Number of pages	9
Journal	Journal of Rheumatology
Volume	38
Issue number	8
DOIs	https://doi.org/10.3899/jrheum.101196
State	Published - Aug 2011

Keywords

Arthritis
Epidemiology
Fracture
Postmenopausal women

ASJC Scopus subject areas

Rheumatology
Immunology and Allergy
Immunology

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10.3899/jrheum.101196

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Wright, N. C., Lisse, J. R., Walitt, B. T., Eaton, C. B., Chen, Z., Nabel, E., Rossouw, J., Ludlam, S., Pottern, L., McGowan, J., Ford, L., Geller, N., Prentice, R., Anderson, G., LaCroix, A., Kooperberg, C. L., Patterson, R. E., McTiernan, A., Shumaker, S., ... Hendrix, S. (2011). Arthritis increases the risk for fractures - Results from the women's health initiative. Journal of Rheumatology, 38(8), 1680-1688. https://doi.org/10.3899/jrheum.101196

Wright, NC, Lisse, JR, Walitt, BT, Eaton, CB, Chen, Z, Nabel, E, Rossouw, J, Ludlam, S, Pottern, L, McGowan, J, Ford, L, Geller, N, Prentice, R, Anderson, G, LaCroix, A, Kooperberg, CL, Patterson, RE, McTiernan, A, Shumaker, S, Stein, E, Cummings, S, Wassertheil-Smoller, S, Rajkovic, A, Manson, JA, Assaf, AR, Phillips, L, Beresford, S, Hsia, J, Chlebowski, R, Whitlock, E, Caan, B, Kotchen, JM, Howard, BV, Van Horn, L, Black, H, Stefanick, ML, Lane, D, Jackson, R, Lewis, CE, Bassford, T, Wactawski-Wende, J, Robbins, J, Hubbell, FA, Nathan, L, Langer, RD, Gass, M, Limacher, M, Curb, D, Wallace, R, Ockene, J, Lasser, N, O'Sullivan, MJ, Margolis, K, Brunner, R, Heiss, G, Kuller, L, Johnson, KC, Brzyski, R, Sarto, GE, Vitolins, M & Hendrix, S 2011, 'Arthritis increases the risk for fractures - Results from the women's health initiative', Journal of Rheumatology, vol. 38, no. 8, pp. 1680-1688. https://doi.org/10.3899/jrheum.101196

@article{0cfed7238a11486085720c578e8b094b,

title = "Arthritis increases the risk for fractures - Results from the women's health initiative",

abstract = "Objective. To examine the relationship between arthritis and fracture. Methods. Women were classified into 3 self-reported groups at baseline: no arthritis (n = 83,295), osteoarthritis (OA; n = 63,402), and rheumatoid arthritis (RA; n = 960). Incident fractures were self-reported throughout followup. Age-adjusted fracture rates by arthritis category were generated, and the Cox proportional hazards model was used to test the association between arthritis and fracture. Results. After an average of 7.80 years, 24,137 total fractures were reported including 2559 self-reported clinical spinal fractures and 1698 adjudicated hip fractures. For each fracture type, age-adjusted fracture rates were highest in the RA group and lowest in the nonarthritic group. After adjustment for several covariates, report of arthritis was associated with increased risk for spine, hip, and any clinical fractures. Compared to the nonarthritis group, the risk of sustaining any clinical fracture in the OA group was HR 1.09 (95% CI 1.05, 1.13; p < 0.001) and HR 1.49 (95% CI 1.26, 1.75; p < 0.001) in the RA group. The risk of sustaining a hip fracture was not statistically increased in the OA group (HR 1.11; 95% CI 0.98, 1.25; p = 0.122) compared to the nonarthritis group; however, the risk of hip fracture increased significantly (HR 3.03; 95% CI 2.03, 4.51; p < 0.001) in the RA group compared to the nonarthritis group. Conclusion. The increase in fracture risk confirms the importance of fracture prevention in patients with RA and OA. The Journal of Rheumatology",

keywords = "Arthritis, Epidemiology, Fracture, Postmenopausal women",

author = "Wright, {Nicole C.} and Lisse, {Jeffrey R.} and Walitt, {Brian T.} and Eaton, {Charles B.} and Zhao Chen and Elizabeth Nabel and Jacques Rossouw and Shari Ludlam and Linda Pottern and Joan McGowan and Leslie Ford and Nancy Geller and Ross Prentice and Garnet Anderson and Andrea LaCroix and Kooperberg, {Charles L.} and Patterson, {Ruth E.} and Anne McTiernan and Sally Shumaker and Evan Stein and Steven Cummings and Sylvia Wassertheil-Smoller and Aleksandar Rajkovic and Manson, {Jo Ann} and Assaf, {Annlouise R.} and Lawrence Phillips and Shirley Beresford and Judith Hsia and Rowan Chlebowski and Evelyn Whitlock and Bette Caan and Kotchen, {Jane Morley} and Howard, {Barbara V.} and {Van Horn}, Linda and Henry Black and Stefanick, {Marcia L.} and Dorothy Lane and Rebecca Jackson and Lewis, {Cora E.} and Tamsen Bassford and Jean Wactawski-Wende and John Robbins and Hubbell, {F. Allan} and Lauren Nathan and Langer, {Robert D.} and Margery Gass and Marian Limacher and David Curb and Robert Wallace and Judith Ockene and Norman Lasser and O'Sullivan, {Mary Jo} and Karen Margolis and Robert Brunner and Gerardo Heiss and Lewis Kuller and Johnson, {Karen C.} and Robert Brzyski and Sarto, {Gloria E.} and Mara Vitolins and Susan Hendrix",

year = "2011",

month = aug,

doi = "10.3899/jrheum.101196",

language = "English (US)",

volume = "38",

pages = "1680--1688",

journal = "Journal of Rheumatology",

issn = "0315-162X",

publisher = "Journal of Rheumatology",

number = "8",

}

TY - JOUR

T1 - Arthritis increases the risk for fractures - Results from the women's health initiative

AU - Wright, Nicole C.

AU - Lisse, Jeffrey R.

AU - Walitt, Brian T.

AU - Eaton, Charles B.

AU - Chen, Zhao

AU - Nabel, Elizabeth

AU - Rossouw, Jacques

AU - Ludlam, Shari

AU - Pottern, Linda

AU - McGowan, Joan

AU - Ford, Leslie

AU - Geller, Nancy

AU - Prentice, Ross

AU - Anderson, Garnet

AU - LaCroix, Andrea

AU - Kooperberg, Charles L.

AU - Patterson, Ruth E.

AU - McTiernan, Anne

AU - Shumaker, Sally

AU - Stein, Evan

AU - Cummings, Steven

AU - Wassertheil-Smoller, Sylvia

AU - Rajkovic, Aleksandar

AU - Manson, Jo Ann

AU - Assaf, Annlouise R.

AU - Phillips, Lawrence

AU - Beresford, Shirley

AU - Hsia, Judith

AU - Chlebowski, Rowan

AU - Whitlock, Evelyn

AU - Caan, Bette

AU - Kotchen, Jane Morley

AU - Howard, Barbara V.

AU - Van Horn, Linda

AU - Black, Henry

AU - Stefanick, Marcia L.

AU - Lane, Dorothy

AU - Jackson, Rebecca

AU - Lewis, Cora E.

AU - Bassford, Tamsen

AU - Wactawski-Wende, Jean

AU - Robbins, John

AU - Hubbell, F. Allan

AU - Nathan, Lauren

AU - Langer, Robert D.

AU - Gass, Margery

AU - Limacher, Marian

AU - Curb, David

AU - Wallace, Robert

AU - Ockene, Judith

AU - Lasser, Norman

AU - O'Sullivan, Mary Jo

AU - Margolis, Karen

AU - Brunner, Robert

AU - Heiss, Gerardo

AU - Kuller, Lewis

AU - Johnson, Karen C.

AU - Brzyski, Robert

AU - Sarto, Gloria E.

AU - Vitolins, Mara

AU - Hendrix, Susan

PY - 2011/8

Y1 - 2011/8

N2 - Objective. To examine the relationship between arthritis and fracture. Methods. Women were classified into 3 self-reported groups at baseline: no arthritis (n = 83,295), osteoarthritis (OA; n = 63,402), and rheumatoid arthritis (RA; n = 960). Incident fractures were self-reported throughout followup. Age-adjusted fracture rates by arthritis category were generated, and the Cox proportional hazards model was used to test the association between arthritis and fracture. Results. After an average of 7.80 years, 24,137 total fractures were reported including 2559 self-reported clinical spinal fractures and 1698 adjudicated hip fractures. For each fracture type, age-adjusted fracture rates were highest in the RA group and lowest in the nonarthritic group. After adjustment for several covariates, report of arthritis was associated with increased risk for spine, hip, and any clinical fractures. Compared to the nonarthritis group, the risk of sustaining any clinical fracture in the OA group was HR 1.09 (95% CI 1.05, 1.13; p < 0.001) and HR 1.49 (95% CI 1.26, 1.75; p < 0.001) in the RA group. The risk of sustaining a hip fracture was not statistically increased in the OA group (HR 1.11; 95% CI 0.98, 1.25; p = 0.122) compared to the nonarthritis group; however, the risk of hip fracture increased significantly (HR 3.03; 95% CI 2.03, 4.51; p < 0.001) in the RA group compared to the nonarthritis group. Conclusion. The increase in fracture risk confirms the importance of fracture prevention in patients with RA and OA. The Journal of Rheumatology

AB - Objective. To examine the relationship between arthritis and fracture. Methods. Women were classified into 3 self-reported groups at baseline: no arthritis (n = 83,295), osteoarthritis (OA; n = 63,402), and rheumatoid arthritis (RA; n = 960). Incident fractures were self-reported throughout followup. Age-adjusted fracture rates by arthritis category were generated, and the Cox proportional hazards model was used to test the association between arthritis and fracture. Results. After an average of 7.80 years, 24,137 total fractures were reported including 2559 self-reported clinical spinal fractures and 1698 adjudicated hip fractures. For each fracture type, age-adjusted fracture rates were highest in the RA group and lowest in the nonarthritic group. After adjustment for several covariates, report of arthritis was associated with increased risk for spine, hip, and any clinical fractures. Compared to the nonarthritis group, the risk of sustaining any clinical fracture in the OA group was HR 1.09 (95% CI 1.05, 1.13; p < 0.001) and HR 1.49 (95% CI 1.26, 1.75; p < 0.001) in the RA group. The risk of sustaining a hip fracture was not statistically increased in the OA group (HR 1.11; 95% CI 0.98, 1.25; p = 0.122) compared to the nonarthritis group; however, the risk of hip fracture increased significantly (HR 3.03; 95% CI 2.03, 4.51; p < 0.001) in the RA group compared to the nonarthritis group. Conclusion. The increase in fracture risk confirms the importance of fracture prevention in patients with RA and OA. The Journal of Rheumatology

KW - Arthritis

KW - Epidemiology

KW - Fracture

KW - Postmenopausal women

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JO - Journal of Rheumatology

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ER -

Arthritis increases the risk for fractures - Results from the women's health initiative

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