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Risk factors associated with the occurrence of hip fracture in Japanese patients with rheumatoid arthritis: a prospective observational cohort study

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Abstract

Summary

Risk factors associated with the occurrence of hip fracture in Japanese patients with rheumatoid arthritis (RA) were evaluated in a prospective, observational cohort study. Physical disability, advanced age, history of total knee replacement (TKR), and low body mass index (BMI) appear to be associated with the occurrence of hip fracture.

Introduction

This study seeks to evaluate the association between potential risk factors and the occurrence of hip fractures in Japanese RA patients.

Methods

A total of 9,720 patients (82.1 % female; mean age, 55.7 years) with RA were enrolled in a prospective observational study from 2000 to 2010. Self-reported hip fractures were verified using patient medical records. Cox proportional hazards models were used to analyze independent contributions of various risk factors to hip fracture occurrence.

Results

During a mean follow-up of 5.2 years, 152 patients reported 152 hip fractures. Among these patients, 97 hip fractures in 97 patients (15 males, 82 females) were verified with medical records. Japanese version of the Health Assessment Questionnaire (J-HAQ) disability score [per 1 score, hazard ratio (HR), 2.64; 95 % confidence interval (CI), 1.94–3.58], age (per 10 years; HR, 1.53; 95 % CI, 1.25–1.87), history of TKR (HR, 3.75; 95 % CI, 1.57–8.96), and BMI (per 1 kg/m2, HR, 0.92; 95 % CI, 0.86–0.99) were significantly associated with hip fractures. Among the scores on the eight domains of the J-HAQ, J-HAQ (arising) (HR, 1.74; 95 % CI, 1.28–2.36) and J-HAQ (hygiene) (HR, 1.58; 95 % CI, 1.11–2.24) were significantly correlated with the occurrence of hip fracture.

Conclusions

High J-HAQ disability score, advanced age, history of TKR, and low BMI appear to be associated with the occurrence of hip fractures in Japanese RA patients. Among the eight domains of the J-HAQ, arising and hygiene disabilities appear to be correlated with the occurrence of hip fractures in this patient population.

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Acknowledgments

We thank all members of the Institute of Rheumatology, Tokyo Women’s Medical University for the successful management of the IORRA cohort and Dr. R. L. Wilder for his useful suggestions.

Funding sources

This work was supported in part by a grant from the Japan Osteoporosis Society (Dr. Furuya). The IORRA cohort was supported by non-restricted research grants from 40 pharmaceutical companies: Abbott Japan Co. Ltd., Asahikasei Kuraray Medical Co. Ltd., Asahikasei Pharma Corporation, Astellas Pharma Inc., AstraZeneca K.K., Bristol-Myers Squibb, Chugai Pharmaceutical Co. Ltd., Daiichi Fine Chemical Co. Ltd., Daiichi Sankyo Co. Ltd., Dainippon Sumitomo Pharma Co. Ltd., Dentsu, Sudler & Hennessey Inc., Eisai Co. Ltd. , GlaxoSmithKline K.K. , Hisamitsu Pharmaceutical Co. Inc., Janssen Pharmaceutical K.K. Japan, Tobacco Inc., Kaken Pharmaceutical Co. Ltd., Kissei Pharmaceutical Co. Ltd., Kowa Pharmaceutical Co. Ltd., Maruho Co. Ltd., Mitsubishi Chemical Medience Corporation, Mitsubishi Tanabe Pharma Corporation, Mochida Pharmaceutical Co. Ltd., MSD K.K., Mundipharma K.K., Nippon Chemiphar Co. Ltd., Nippon Shinyaku Co. Ltd., Novartis Pharma K.K., Otsuka Pharmaceutical Co. Ltd., Pfizer Japan Inc., Sanofi-Aventis K.K., Santen Pharmaceutical Co. Ltd., Sanwa Kagaku Kenkyusho Co. Ltd., Sekisui Medical Co. Ltd., Shionogi Co. Ltd., Taishotoyama Pharmaceutical Co. Ltd, Takeda Pharmaceutical Company Limited, Teijin Pharma Limited, Torii Pharmaceutical Co. Ltd., UCB Japan Co. Ltd., and ZERIA Pharmaceutical Co. Ltd.

Conflict of interest

HY has received consulting and/or speaking fee from: Abbott Japan Co. Ltd., AstraZeneca K.K., Bristol-Myers Squibb, Chugai Pharmaceutical Co. Ltd., Eisai Co. Ltd., Janssen Pharmaceutical K.K. Japan, Mitsubishi Tanabe Pharma Corporation, Pfizer Japan Inc., Takeda Pharmaceutical Co. Ltd., Teijin Pharma Limited, and UCB Japan Co. Ltd. The rest of authors have no conflict of interest to state.

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Authors and Affiliations

  1. Institute of Rheumatology, Tokyo Women’s Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo, 162-0054, Japan

    T. Furuya, E. Inoue, A. Taniguchi, S. Momohara & H. Yamanaka

  2. Department of Clinical Research and Development, National Center for Geriatrics and Gerontology, 35 Gengo, Morioka-machi, Obu City, Aichi, 474-8511, Japan

    T. Hosoi

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  1. T. Furuya
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  2. E. Inoue
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  3. T. Hosoi
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  6. H. Yamanaka
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Correspondence to T. Furuya.

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Furuya, T., Inoue, E., Hosoi, T. et al. Risk factors associated with the occurrence of hip fracture in Japanese patients with rheumatoid arthritis: a prospective observational cohort study. Osteoporos Int 24, 1257–1265 (2013). https://doi.org/10.1007/s00198-012-2080-0

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