Estimation of 10-Year Fracture Risk with and without Bone Mineral Density in Patients with Rheumatoid Arthritis

Area of Science:

• Rheumatology
• Orthopedics
• Endocrinology

Background:

• Rheumatoid arthritis (RA) is a common inflammatory condition with potential extra-articular effects.
• Fracture risk is a significant concern in RA patients, potentially underestimated without bone mineral density (BMD) assessment.

Purpose of the Study:

• To evaluate discrepancies in fracture risk estimation in rheumatoid arthritis patients with and without bone mineral density (BMD) data.
• To determine the impact of BMD on FRAX score calculations for major and hip osteoporotic fractures.

Main Methods:

• An observational, cross-sectional study involving 65 RA patients aged 40-90 years.
• Fracture risk was assessed using the FRAX score, both with and without BMD measurements.
• Statistical analysis, including multivariate analysis, was performed to identify significant predictors of fracture risk.

Main Results:

• Incorporating BMD increased the number of patients classified as high-risk for major and hip fractures.
• Over half of patients aged 55 and above were identified as high-risk after BMD inclusion.
• Age was the only statistically significant factor in multivariate analysis, though increasing age, female sex, disease duration, and steroid use correlated with higher FRAX scores.

Conclusions:

• A significant proportion of rheumatoid arthritis patients, particularly those over 55, are at high risk for fractures, especially hip fractures.
• Bone mineral density (BMD) assessment is essential for accurate fracture risk stratification in RA patients.
• Routine BMD testing should be considered for RA patients over 55 years of age to guide preventative strategies.