Factors Influencing Fracture Risk, T Score, and Management of Osteoporosis in Patients With Rheumatoid Arthritis in the Consortium of Rheumatology Researchers of North America (CORRONA) Registry
Factors Influencing Fracture Risk, T Score, and Management of Osteoporosis in Patients With Rheumatoid Arthritis in the Consortium of Rheumatology Researchers of North America (CORRONA) Registry
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DOI：
10.1097/rhu.0b013e3181a5679d
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发表时间：
2009-06-01
影响因子：
3.4
通讯作者：
Pepmueller, Peri H.
中科院分区：
文献类型：
--
作者：
Coulson, Kathryn A.;Reed, George;Pepmueller, Peri H.
目的：本研究检查了广泛的临床因素，以评估其对类风湿关节炎（RA）女性患者骨折风险和T评分的影响，并确定骨质疏松症（OP）风险的RA女性患者是否充分使用OP药物。方法：数据来自2002年3月参加北美流变学研究者联盟登记的8419名女性RA患者，2006年8月15日至2006年8月15日进行了评估。协变量包括药物亚组、人口统计学和临床参数。腰椎和髋关节T评分和骨折率与变量的关系进行了研究。使用OP药物的患者与OP的危险因素evaluated.Results：绝经后状态和较高的改良健康评估问卷评分（mHAQ）腰椎评分有负面影响，而婚姻，教育和体重指数有积极的影响。髋关节T评分也有类似的趋势。总体骨折风险的增加与绝经后状态、mHAQ和泼尼松的使用相关，而肿瘤坏死因子单药治疗与总体骨折风险的降低相关。mHAQ也与非髋关节/非脊柱骨折相关。80%的患者至少有一个OP的风险因素，但只有32%的患者服用OP药物。只有54%的患者与3个危险因素OP medication.Conclusions：在RA，绝经后状态，mHAQ，和强的松的使用与较高的整体骨折风险。有OP风险的RA女性可能未充分接受OP药物治疗。
Objectives: This study examined a wide array of clinical factors to evaluate their influence on fracture risk and T scores in women with rheumatoid arthritis (RA) and determine if women with RA who are at risk for osteoporosis (OP) are adequately created with OP medications.Methods: Data from 8419 female RA patients participating in the Consortium of Rheumatology Researchers of North America registry from March 02, 2006 to August 15, 2006 was evaluated. Covariates included medication subgroups, demographic, and clinical parameters. Lumbar spine and hip T scores and fracture rates were studied in relation to the variables. Use of OP medications in patients with OP risk factors was also evaluated.Results: Postmenopausal status and higher modified health assessment questionnaire score (mHAQ) had a negative effect on lumbar spine score, while marriage, education, and body mass index had a positive effect. A similar trend was found with hip T scores. Increase in overall fracture risk correlated with postmenopausal status, mHAQ, and prednisone use, while tumor necrosis factor monotherapy was associated with decreased overall fracture risk. mHAQ was also associated with nonhip/nonspine fractures. Eighty percent of patients had at least 1 risk factor for OP, but only 32% were on OP medications. Only 54% of patients with 3 risk factors were on OP medication.Conclusions: In RA, postmenopausal status, mHAQ, and prednisone use were associated with a higher overall fracture risk. Women with RA who were at risk for OP may have been inadequately treated with OP medications.