Management of bone fragility in patients with rheumatoid arthritis in France: An analysis of a national health insurance claims database.
Joint Bone Spine
; 89(4): 105340, 2022 07.
Article
em En
| MEDLINE
| ID: mdl-34995758
ABSTRACT
OBJECTIVES:
Rheumatoid arthritis (RA) is considered a major risk factor for fragility fractures. We examined the quality of management of bone fragility in RA patients in a real-life setting.METHODS:
We performed a longitudinal case-control retrospective study in a 1/97th random sample of French health care claims database from 2014 to 2016 to determine the extent of bone fragility management in patients with RA compared with non-RA matched controls.RESULTS:
Compared to their non-RA controls (n=4652), RA patients (n=1008; mean age 61.1years; methotrexate 69.7%; other conventional disease-modifying antirheumatic drugs (cDMARDs) 26.8%; biologic 26.0%; corticosteroids 36.9%) had more reimbursements for bone mineral density (BMD) measurements (21.6 vs. 9.2%; OR=2.7 [2.3; 3.3]; P<0.01) and for bisphosphonates (7.1 vs. 3.6%, OR=2.0 [1.5; 2.7]; P<0.05). In patients exposed to corticosteroids, RA patients underwent more BMD assessments than non-RA controls (28.0 vs. 18.8%; OR=1.7 [1.3; 2.2]; P<0.05). RA patients exposed to corticosteroids were more likely to sustain fracture than non-exposed RA patients (5.7 vs. 2.4%, P<0.01). In addition, only when comparing patients exposed to corticosteroids, was there statistical evidence of an association between RA and an increased fracture rate (6.2 vs. 3.5%, P<0.05).CONCLUSION:
Patients with RA exposed to corticosteroids are at high risk of fracture. Patients with RA had more bone fragility management than controls.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Artrite Reumatoide
/
Antirreumáticos
/
Fraturas Ósseas
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Humans
/
Middle aged
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article