Related Experiment Video
Updated: Oct 16, 2025
Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain
Published on: May 16, 2025
Risk of Non-Vertebral Fracture in Gout Compared to Rheumatoid Arthritis
Soo-Kyung Cho1,2, Jun Liu1, Yinzhu Jin1
1Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA.
Insights
Patients with gout had a lower risk of non-vertebral and hip fractures compared to those with rheumatoid arthritis (RA). Despite this, fractures were common in both conditions, highlighting the need for fracture prevention strategies in gout and RA management.
Area of Science:
- Rheumatology
- Orthopedics
- Epidemiology
Background:
- Rheumatoid arthritis (RA) is associated with an increased risk of fractures.
- Gout is a common inflammatory arthritis, but its association with fracture risk is less understood.
- Understanding fracture risk in gout versus RA is crucial for patient management.
Purpose of the Study:
- To compare the risk of non-vertebral fractures between patients with gout and patients with rheumatoid arthritis (RA).
- To specifically assess the risk of hip fractures in gout versus RA patients.
Main Methods:
- A 1:1 matched cohort study using Medicare claims data (2008-2015) of 134,157 patients with gout and RA.
- Fractures (hip, pelvis, humerus, wrist) were identified using validated algorithms.
- Multivariable Cox proportional hazards regression was used to estimate hazard ratios, adjusting for 45 covariates.
Main Results:
- Patients with gout had a lower incidence rate of non-vertebral fractures (10.42/1000 PY) and hip fractures (4.86/1000 PY) compared to RA patients (15.01 and 7.73/1000 PY, respectively).
- The adjusted hazard ratio for non-vertebral fractures was 0.84 (95% CI 0.80-0.88) and for hip fractures was 0.76 (95% CI 0.71-0.82) in gout versus RA.
- Comorbidities differed, with RA patients having more fracture risk factors and gout patients having more obesity, coronary heart disease, hypertension, and diabetes.
Conclusions:
- Gout is associated with a modestly decreased risk of non-vertebral and hip fractures compared to rheumatoid arthritis in older adults.
- Non-vertebral fractures remain a significant concern in both gout and RA populations.
- Further research into fracture prevention in these patient groups is warranted.
Objective:
To evaluate the risk of non-vertebral fractures in patients with gout compared with those with rheumatoid arthritis (RA).
Methods:
Using claims data from Medicare (2008-2015), we conducted a cohort study of patients with gout versus RA matched on age, sex, and index date with a 1:1 ratio. The primary outcome was a composite endpoint of non-vertebral fractures including hip, pelvis, humerus, and wrist identified with the validated algorithms. We also assessed hip fractures separately. Multivariable Cox proportional hazards regression estimated the hazard ratio (HR) for the outcomes in gout versus RA adjusted for 45 covariates.
Results:
We included a total of 134,157 matched pairs of gout and RA patients (mean age: 73.7 years). Risk factors for fracture were more prevalent in RA, while other comorbidities including obesity, coronary heart disease, hypertension, and diabetes were more common in gout. Over the mean 2.8 years follow-up, the incidence rate (IR)/1000 person-year (PY) of non-vertebral fractures was 10.42 in gout and 15.01 in RA. For hip fractures, the IR/1000 PY was 4.86 in gout and 7.73 in RA. The multivariable HR associated with gout versus RA was 0.84 (95% confidence interval (CI) 0.80-0.88) for non-vertebral fractures and 0.76 (95% CI 0.71-0.82) for hip fractures. Stratified analyses by age, sex, prior fractures, steroid use, and TNF inhibitor use showed similar results.
Conclusions:
In this large cohort of older patients, gout was associated with a modestly decreased risk of non-vertebral or hip fractures versus RA. However, non-vertebral fractures occurred frequently in both gout and RA.
Related Concept Videos
01:11Genome-wide Association Studies-GWAS
GWAS does not require the identification of the target gene involved in...
01:23Rheumatic Heart Disease I: Introduction
01:21Rheumatic Heart Disease III: Medical Management
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:12Relative Risk
01:20Rheumatic Heart Disease IV: Nursing Management