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Risk of Non-Vertebral Fracture in Gout Compared to Rheumatoid Arthritis
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....
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8539966/ https://www.ncbi.nlm.nih.gov/pubmed/34682784 http://dx.doi.org/10.3390/jcm10204655 |
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author | Cho, Soo-Kyung Liu, Jun Jin, Yinzhu Kim, Seoyoung C. |
author_facet | Cho, Soo-Kyung Liu, Jun Jin, Yinzhu Kim, Seoyoung C. |
author_sort | Cho, Soo-Kyung |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-8539966 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-85399662021-10-24 Risk of Non-Vertebral Fracture in Gout Compared to Rheumatoid Arthritis Cho, Soo-Kyung Liu, Jun Jin, Yinzhu Kim, Seoyoung C. J Clin Med Article 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. MDPI 2021-10-11 /pmc/articles/PMC8539966/ /pubmed/34682784 http://dx.doi.org/10.3390/jcm10204655 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Cho, Soo-Kyung Liu, Jun Jin, Yinzhu Kim, Seoyoung C. Risk of Non-Vertebral Fracture in Gout Compared to Rheumatoid Arthritis |
title | Risk of Non-Vertebral Fracture in Gout Compared to Rheumatoid Arthritis |
title_full | Risk of Non-Vertebral Fracture in Gout Compared to Rheumatoid Arthritis |
title_fullStr | Risk of Non-Vertebral Fracture in Gout Compared to Rheumatoid Arthritis |
title_full_unstemmed | Risk of Non-Vertebral Fracture in Gout Compared to Rheumatoid Arthritis |
title_short | Risk of Non-Vertebral Fracture in Gout Compared to Rheumatoid Arthritis |
title_sort | risk of non-vertebral fracture in gout compared to rheumatoid arthritis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8539966/ https://www.ncbi.nlm.nih.gov/pubmed/34682784 http://dx.doi.org/10.3390/jcm10204655 |
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