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Vertebral fractures affect functional status in postmenopausal rheumatoid arthritis patients

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Abstract

Functional disability is a major concern in patients with rheumatoid arthritis (RA). This retrospective study investigated the risk factors for vertebral fractures (VFs) in postmenopausal RA patients and determined the impact of VFs on functional status. Data from a cohort of 200 postmenopausal RA patients in a single hospital registry were analyzed. Demographic and clinical data, imaging data from spine radiographs, and bone mineral density (BMD) data were collected from the patients at baseline and at the final visit (a mean of 2.9 years after the first visit). Risk factors for incident VFs and their impact on the modified health assessment questionnaire (mHAQ) were analyzed. Twenty-eight patients (14 %) developed new VFs (NVFs). Logistic regression analysis adjusted for age, BMI, and disease duration revealed that daily dose of prednisolone, femoral neck BMD, use of active vitamin D3, and use of a bisphosphonate at baseline were factors associated with NVF, with odds ratios (95 % confidence interval) of 1.27 (1.05–1.54), 0.94 (0.91–0.97), 0.34 (0.13–0.89), and 0.31 (0.12–0.82), respectively. Patients with NVF exhibited worse mHAQ scores and a greater increase in mHAQ scores from baseline compared with those without NVF. In conclusion, incident VFs were associated with reduced functional status in postmenopausal patients with RA. It is important to prevent VFs to maintain the functional status of RA patients.

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Conflict of interest

The authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan

    Yasunori Omata, Yuho Kadono, Yuichi Nagase, Jun Hirose, Tetsuro Yasui, Takumi Matsumoto & Sakae Tanaka

  2. Department of Rheumatology, Sagamihara National Hospital, National Hospital Organization, Kanagawa, Japan

    Futoshi Hagiwara, Hisanori Nakayama, Toshihiro Matsui & Shigeto Tohma

  3. Nishino Clinic Orthopedics and Rheumatology, Tokyo, Japan

    Jinju Nishino

  4. Clinical Research Center for Occupational Musculoskeletal Disorders, Kanto Rosai Hospital, Kanagawa, Japan

    Ko Matsudaira

  5. Department of Orthopaedic Surgery, Sagamihara National Hospital, National Hospital Organization, Kanagawa, Japan

    Takuo Juji & Toshihito Mori

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  1. Yasunori Omata
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  2. Futoshi Hagiwara
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  3. Jinju Nishino
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  14. Shigeto Tohma
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  15. Sakae Tanaka
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Correspondence to Sakae Tanaka.

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Omata, Y., Hagiwara, F., Nishino, J. et al. Vertebral fractures affect functional status in postmenopausal rheumatoid arthritis patients. J Bone Miner Metab 32, 725–731 (2014). https://doi.org/10.1007/s00774-013-0552-8

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  • DOI: https://doi.org/10.1007/s00774-013-0552-8

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