RA tied to poor survival after fracture

Individuals with rheumatoid arthritis (RA) appear to be at increased risk of death following a fracture, reveals a study, noting that post-fracture survival has not improved despite therapeutic advances over the past decades.

“Consequently, this study emphasizes the need to better understand and treat fractures in RA to improve the lives of these patients,” the authors said.

RA correlated with a significantly worse survival after fracture (hazard ratio [HR], 1.28, 95 percent confidence interval [CI], 1.18‒1.39). Notably, post-fracture survival did not improve from 1990‒1999 to 2000‒2010 in both RA patients and controls (RA vs controls: HR, 0.95, 95 percent CI, 0.75‒1.20 vs 0.86, 95 percent CI, 0.71‒1.04).

Moreover, RA appeared to contribute to increased episodes of hospital-based care (odds ratio, 1.27, 95 percent CI, 1.08‒1.48).

This case-control matched retrospective cohort study using routinely collected administrative health data from public and private hospital in Western Australia involved 1,304 patients with RA. The authors evaluated survival after an initial fracture.

“RA is a potentially devastating autoimmune disease associated with multiple comorbidities, including osteoporosis and cardiovascular disease, which exert significant morbidity and mortality burdens,” the authors said.

“Despite the recognized connection between RA and fracture risk, few studies have evaluated post-fracture survival in RA, and no studies have evaluated the effect of RA on post-fracture survival between 1990 and 2010, when there was a rapid growth in disease-modifying antirheumatic drug availability in combination with a paradigm shift in the understanding of RA,” they added.