Our aim was to analyze trends in fracture rates in SpA patients over an extended time period. Only an increase of axial fractures, more specifically vertebral fractures, is observed in SpA.
To analyze fracture incidence and trend in patients with spondyloarthritis (SpA) over an extended time period.
Retrospective observational population-based study with matched cohorts. Data from the Minimum Basic Data Set (MBDS) of Spain were reviewed. All SpA patient hospitalizations reported from 1999 to 2015 (SpA cohort) were analyzed. A control cohort (non-SpA cohort) matched by age, sex, region, and year of hospitalization was recruited. The age and sex-adjusted crude incidence rate was calculated for any fractures (axial and peripheral). Generalized linear models (GLM) were used for trend analysis. Association between fracture type and SpA (and its subtypes) was assessed using unconditional logistic regression models.
In the SpA cohort, the age and sex-adjusted rates per 100,000 inhabitants/year of total fracture and different types of fracture were 45.72 any fractures, 17.64 axial, and 28.02 peripheral; 29.42 osteoporotic (12.67 vertebra, 12.29 hip, 1.50 pelvis, 1.82 humerus and 2.09 radius). In the non-SpA cohort, they were 65.79 any, 12.08 axial, 51.52 peripheral; 31.17 osteoporotic (4.94 vertebra, 16.15 hip, 2.29 pelvis, 3.64 humerus, 5.38 radius). Between 1999 and 2015, the trend in incidence rate for total fracture and different types of fracture increased similarly for both cohorts. In the SpA cohort, an increase of axial fractures was found (AOR 1.444; 95%CI 1.297–1.609), and specifically of vertebral fractures (AOR 2.440; 95%CI 2.097–2.839). Other types of fractures did not increase.
Only an increase of axial fractures, more specifically vertebral fractures, is observed in SpA. Trend in incidence is similar in both cohorts.
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The authors thank the staff of the Research Unit of the Spanish Society of Rheumatology (SER) for their support in the translation of this manuscript.
To my good friend Caligula who faithfully accompanies me in my research work.
This study was supported by a research grant from Pfizer (Pfizer 61029829) to RM.
The Hospital Fundación Alcorcon’s Ethics Committee (ref 18/135) evaluated the present project and approved it on December 18th, 2018.
Conflicts of interest
Ramón Mazzucchelli received research grants from Pfizer, Roche, and Amgen due to different projects in the past. The rest of authors have no conflicts of interest to declare. The study is based on data obtained from the Minimum Basic Data Set (MBDS) of Spain provided by its Ministry of Health and Welfare. The interpretation and conclusions do not necessarily represent those of this Ministry.
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Mazzucchelli, R., Almodovar, R., Dieguez-Costa, E. et al. Trends in fractures in patients with spondyloarthritis: a nationwide population-based study (TREND-EspA study) . Osteoporos Int (2021). https://doi.org/10.1007/s00198-021-06079-y
- Hip fracture
- Vertebral fracture