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Risk factors associated with the occurrence of distal radius fractures in Japanese patients with rheumatoid arthritis: a prospective observational cohort study

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Abstract

The aims of this study were to evaluate the association between potential risk factors and the occurrence of distal radius fractures in Japanese patients with rheumatoid arthritis (RA). A total of 9,987 patients (82.0 % female; mean age, 55.7 years) with RA were enrolled in a prospective, observational study from 2000 to 2011. Self-reported distal radius fractures were verified using patient medical records. Cox proportional hazards models were used to analyze independent contributions of various risk factors to distal radius fracture occurrence. During a mean follow-up of 5.7 years, 139 patients reported 153 distal radius fractures. Among these patients, 85 distal radius fractures following minor trauma in 85 patients (6 men, 79 women) were verified with medical records. Female gender (hazard ratio [HR], 2.96; 95 % confidence interval [CI], 1.18–7.45; P = 0.021), age (per 10 years, HR 1.55; 95 % CI, 1.24–1.95, P = 0.00016), body mass index (BMI) (per 1 kg/m2, HR, 1.11; 95 % CI, 1.03–1.19; P = 0.0034), daily prednisolone dose (per milligram per day, HR, 1.10; 95 % CI, 1.05–1.16; P = 0.00015), and physician global visual analog scale (0–10 cm, HR, 0.98; 95 % CI, 0.96–1.00; P = 0.034) were significantly associated with the occurrence of distal radius fractures in Japanese patients with RA. A reduction in the daily prednisolone dose, together with the prevention of falls in female patients of advanced age with RA and a high BMI may be important in preventing distal radius fractures.

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Acknowledgments

We thank Dr. Eisuke Inoue and all members of the Institute of Rheumatology, Tokyo Women's Medical University for the successful management of the IORRA cohort. We also thank Prof. Y. Toyama and other members of the Department of Orthopedic Surgery, Keio University School of Medicine for their support.

Funding sources

This work was supported in part by grants-in-aid for scientific research from the Japan Society for the Promotion of Science to KO, by the Nakatomi Foundation and the Japan Orthopaedics and Traumatology Foundation to KO, and from the Japan Osteoporosis Society to TF. The IORRA cohort was supported by non-restricted research grants from 34 pharmaceutical companies: AbbVie GK, Asahikasei Pharma Corporation, Astellas Pharma Inc., Bristol-Myers Squibb, Chugai Pharmaceutical Co., Ltd., Daiichi Fine Chemical Co., Ltd., Daiichi Sankyo Co., Ltd., Dainippon Sumitomo Pharma Co., Ltd., Eisai Co., Ltd., GlaxoSmithKline K.K., Hisamitsu Pharmaceutical Co., Inc., Japan Tobacco Inc., Kaken Pharmaceutical Co., Ltd., Kissei Pharmaceutical Co., Ltd., Kyowa Hakko Kirin Co., Ltd., Maruho Co., Ltd., Mitsubishi Tanabe Pharma Corporation, MSD K.K., Nippon Chemiphar Co., Ltd., Nippon Katyaku Co., Ltd., Nippon Shinyaku Co., Ltd., Novartis Pharma K.K., Ono Pharmaceutical Co., Ltd., Otsuka Pharmaceutical Co., Ltd., Pfizer Japan Inc., Santen Pharmaceutical Co., Ltd., Sekisui Medical Co., Ltd., Shionogi Co., Ltd., Taishotoyama Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co. Ltd., Teijin Pharma Limited, Torii Pharmaceutical Co., Ltd., UCB Japan Co. Ltd., ZERIA Pharmaceutical Co., Ltd.

Conflict of interest

HY has received research grants from: Abbott, AbbVie, Asahikasei, Astellas, AstraZeneca, Bristol-Myers Squibb, Chugai, Daiichi Sankyo, Eisai, GlaxoSmithKline, Janssen, Mitsubishi Tanabe, MSD, Nippon Kayaku, Pfizer, Santen, Taishotoyama, Takeda, and Teijin, consulting fees from: Abbott, AbbVie, Astellas, AstraZeneca, Bristol-Myers Squibb, Chugai, Daiichi Sankyo, Eisai, Mitsubishi Tanabe, Nippon Kayaku, Pfizer, Takeda, and Teijin, and is a member of the Speakers bureaus of: Abbott, AbbVie, Astellas, Bristol-Myers Squibb, Chugai, Eisai, Mitsubishi Tanabe, Pfizer, Takeda, and Teijin. The remaining authors have no conflicts 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

    Kensuke Ochi, Yuki Go, Takefumi Furuya, Katsunori Ikari, Atsuo Taniguchi, Hisashi Yamanaka & Shigeki Momohara

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  1. Kensuke Ochi
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  2. Yuki Go
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  3. Takefumi Furuya
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  4. Katsunori Ikari
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  5. Atsuo Taniguchi
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  7. Shigeki Momohara
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Correspondence to Takefumi Furuya.

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Ochi, K., Go, Y., Furuya, T. et al. Risk factors associated with the occurrence of distal radius fractures in Japanese patients with rheumatoid arthritis: a prospective observational cohort study. Clin Rheumatol 33, 477–483 (2014). https://doi.org/10.1007/s10067-013-2415-z

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