Occurrence and relative risks for non-vertebral fractures in patients with ankylosing spondylitis compared with the general population : a register-based study from Sweden
(2023) In RMD Open 9(1).- Abstract
OBJECTIVES: To estimate the incidence of non-vertebral fractures in ankylosing spondylitis (AS) compared with the general population. METHODS: Nationwide register-based cohort study including patients with AS (n=11 611, 65% men, mean age 48 years), and matched general population controls (n=58 050). Five prespecified fracture outcomes: (1) non-vertebral; (2) fracture of the proximal humerus, distal forearm or hip; (3) proximal humerus; (4) distal forearm and (5) hip) were identified through register linkages with follow-up 2007-2016. We used Poisson regression to calculate incidence rates (IRs), number of fractures per 1000 person-years at risk and IR ratios (IRRs), overall and by sex and age. IRRs were adjusted for history of any prior... (More)
OBJECTIVES: To estimate the incidence of non-vertebral fractures in ankylosing spondylitis (AS) compared with the general population. METHODS: Nationwide register-based cohort study including patients with AS (n=11 611, 65% men, mean age 48 years), and matched general population controls (n=58 050). Five prespecified fracture outcomes: (1) non-vertebral; (2) fracture of the proximal humerus, distal forearm or hip; (3) proximal humerus; (4) distal forearm and (5) hip) were identified through register linkages with follow-up 2007-2016. We used Poisson regression to calculate incidence rates (IRs), number of fractures per 1000 person-years at risk and IR ratios (IRRs), overall and by sex and age. IRRs were adjusted for history of any prior fracture. RESULTS: IRs (men/women) for non-vertebral fracture in AS were 11.9 (95% CI 11.0 to 12.9)/14.5 (95% CI 13.1 to 16.1) and in controls 10.0 (95% CI 9.7 to 10.4)/11.8 (95% CI 11.1 to 12.4), IRR (men/women) 1.2 (95% CI 1.1 to 1.3)/1.2 (95% CI 1.1 to 1.4). IRs (men/women) for fractures of the humerus, forearm or hip in AS were 4.0 (95% CI 3.5 to 4.6)/6.3 (95% CI 5.4 to 7.3) and in controls 2.7 (95% CI 2.5 to 2.9)/5.5 (95% CI 5.1 to 6.0), IRR (men/women) 1.5 (95% CI 1.3 to 1.7)/1.1 (95% CI 0.9 to 1.3). IRRs were statistically significantly elevated in men with AS versus controls for forearm fracture (1.4 (95% CI 1.1 to 1.7)) and hip fracture (1.8 (95% CI 1.4 to 2.3)), whereas not in women with AS where the IRRs were 1.1 (95% CI 0.9 to 1.4) and 1.0 (95% CI 0.6 to 1.4). For humerus fracture, IRRs were 1.4 (95% CI 0.99 to 1.9) in men with AS versus controls and 1.1 (95% CI 0.8 to 1.6) in women. CONCLUSIONS: Both men and women with AS have a slightly higher risk of non-vertebral fractures than the general population. A statistically significantly higher risk of fractures of the proximal humerus, distal forearm or hip was found in men with AS in comparison to general population, where the relative risk was especially pronounced for hip fracture.
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- author
- Bengtsson, Karin ; Askling, Johan ; Lorentzon, Mattias ; Rosengren, Björn LU ; Deminger, Anna ; Klingberg, Eva ; Jacobsson, Lennart and Forsblad-d'Elia, Helena
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- epidemiology, osteoporosis, spondylitis, ankylosing
- in
- RMD Open
- volume
- 9
- issue
- 1
- publisher
- BMJ Publishing Group
- external identifiers
-
- pmid:36787924
- scopus:85148049531
- ISSN
- 2056-5933
- DOI
- 10.1136/rmdopen-2022-002753
- language
- English
- LU publication?
- yes
- id
- 37f9664d-15de-41f1-bedd-e66fc179db4d
- date added to LUP
- 2023-03-06 12:48:13
- date last changed
- 2024-04-16 02:23:28
@article{37f9664d-15de-41f1-bedd-e66fc179db4d,
abstract = {{<p>OBJECTIVES: To estimate the incidence of non-vertebral fractures in ankylosing spondylitis (AS) compared with the general population. METHODS: Nationwide register-based cohort study including patients with AS (n=11 611, 65% men, mean age 48 years), and matched general population controls (n=58 050). Five prespecified fracture outcomes: (1) non-vertebral; (2) fracture of the proximal humerus, distal forearm or hip; (3) proximal humerus; (4) distal forearm and (5) hip) were identified through register linkages with follow-up 2007-2016. We used Poisson regression to calculate incidence rates (IRs), number of fractures per 1000 person-years at risk and IR ratios (IRRs), overall and by sex and age. IRRs were adjusted for history of any prior fracture. RESULTS: IRs (men/women) for non-vertebral fracture in AS were 11.9 (95% CI 11.0 to 12.9)/14.5 (95% CI 13.1 to 16.1) and in controls 10.0 (95% CI 9.7 to 10.4)/11.8 (95% CI 11.1 to 12.4), IRR (men/women) 1.2 (95% CI 1.1 to 1.3)/1.2 (95% CI 1.1 to 1.4). IRs (men/women) for fractures of the humerus, forearm or hip in AS were 4.0 (95% CI 3.5 to 4.6)/6.3 (95% CI 5.4 to 7.3) and in controls 2.7 (95% CI 2.5 to 2.9)/5.5 (95% CI 5.1 to 6.0), IRR (men/women) 1.5 (95% CI 1.3 to 1.7)/1.1 (95% CI 0.9 to 1.3). IRRs were statistically significantly elevated in men with AS versus controls for forearm fracture (1.4 (95% CI 1.1 to 1.7)) and hip fracture (1.8 (95% CI 1.4 to 2.3)), whereas not in women with AS where the IRRs were 1.1 (95% CI 0.9 to 1.4) and 1.0 (95% CI 0.6 to 1.4). For humerus fracture, IRRs were 1.4 (95% CI 0.99 to 1.9) in men with AS versus controls and 1.1 (95% CI 0.8 to 1.6) in women. CONCLUSIONS: Both men and women with AS have a slightly higher risk of non-vertebral fractures than the general population. A statistically significantly higher risk of fractures of the proximal humerus, distal forearm or hip was found in men with AS in comparison to general population, where the relative risk was especially pronounced for hip fracture.</p>}},
author = {{Bengtsson, Karin and Askling, Johan and Lorentzon, Mattias and Rosengren, Björn and Deminger, Anna and Klingberg, Eva and Jacobsson, Lennart and Forsblad-d'Elia, Helena}},
issn = {{2056-5933}},
keywords = {{epidemiology; osteoporosis; spondylitis, ankylosing}},
language = {{eng}},
number = {{1}},
publisher = {{BMJ Publishing Group}},
series = {{RMD Open}},
title = {{Occurrence and relative risks for non-vertebral fractures in patients with ankylosing spondylitis compared with the general population : a register-based study from Sweden}},
url = {{http://dx.doi.org/10.1136/rmdopen-2022-002753}},
doi = {{10.1136/rmdopen-2022-002753}},
volume = {{9}},
year = {{2023}},
}