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Association of Rheumatoid Arthritis With Postfracture Mortality and Fracture-Related Care
Owen Taylor-Williams1, Johannes Nossent2, Charles A Inderjeeth3
1O. Taylor-Williams, MD, BSc, Royal Perth Hospital, and University of Western Australia, and Joondalup Health Campus, Perth; owen.taylor-williams@research.uwa.edu.au.
The Journal of Rheumatology
|November 15, 2025
Summary
People with Rheumatoid Arthritis (RA) face worse survival after fractures. Despite advances in treatments, survival rates have not improved between 1990-2010, highlighting a critical need for better fracture management in RA patients.
Area of Science:
- Rheumatology
- Osteoporosis Research
- Epidemiology
Background:
- Rheumatoid Arthritis (RA) is an autoimmune disease linked to increased fracture risk and comorbidities like osteoporosis.
- Limited research exists on post-fracture survival in RA patients, especially during periods of significant treatment advancements.
Purpose of the Study:
- To evaluate the impact of Rheumatoid Arthritis (RA) on survival following a fracture.
- To assess changes in post-fracture survival for RA patients between 1990-2010.
- To investigate the association between RA and fracture-related re-presentations.
Main Methods:
- A retrospective cohort study utilizing administrative health data from Western Australia.
- Involved 1304 Rheumatoid Arthritis (RA) patients in a case-control matched analysis.
- Assessed survival and fracture-related re-presentations post-fracture.
Main Results:
- Rheumatoid Arthritis (RA) was significantly associated with poorer survival after fracture (HR 1.28).
- Post-fracture survival did not improve from 1990-1999 to 2000-2010 for RA patients or controls.
- RA patients had increased odds of fracture-related re-presentations (OR 1.27).
Conclusions:
- Individuals with Rheumatoid Arthritis (RA) experience worse survival outcomes after fractures.
- Survival post-fracture in RA has not improved despite therapeutic advancements over recent decades.
- There is an urgent need for enhanced understanding and treatment of fractures in the RA population.
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