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Clinical Summary

Osteoarthritis and the Incidence of Fracture in the UK

Takeaway

  • Osteoarthritis (OA) was positively associated with the incidence of fractures.
  • This association between OA and fracture was significant in all sex, age and OA joint site subgroups.

Why this matters

  • Findings highlight the urgent need for intervention to reduce the risk of fracture in adults with OA.
  • Future studies are warranted to gain a better insight into the mediators involved in the association between OA and fracture.

Study design

  • A retrospective cohort study of 129,348 patients who had received an initial diagnosis of OA (aged, ≥18 years) in one of 256 general practices in the UK between 1997 and 2016 (index date).
  • Patients with OA were matched (1:1) to those without OA by sex, age, index year, diabetes, dementia, corticosteroid therapy and practice.
  • All patients were followed from the index date for up to 10 years for incidence of any fracture.
  • Funding: None.

Key results

  • After 10 years of follow-up, 12.1% of participants with OA and 7.7% of those without OA had suffered ≥1 fracture (log-rank P<.001).
  • A positive and significant association was seen between OA and fracture (HR, 1.55; 95% CI, 1.50-1.60; P<.001). 
  • The association between OA and fracture was significant in all sex, age and OA joint site subgroups (HR; 95% CI):
    • men (1.58; 1.48-1.69);
    • women (1.55; 1.49-1.61);
    • age 18-50 years (1.62; 1.48-1.78);
    • age 51-60 years (1.40; 1.30-1.51);
    • age 61-70 years (1.42; 1.32-1.53);
    • age 71-80 years (1.56; 1.45-1.67);
    • age >80 years (1.61; 1.47-1.75);
    • polyarthritis group (1.60; 1.41-1.81);
    • hip OA group (1.40; 1.23-1.60);
    • knee OA group (1.36; 1.16-1.59); and
    • other and unspecified OA group (1.57; 1.51-1.63).

Limitations

  • Retrospective design.
 

Jacob L, Kostev K. Osteoarthritis and the incidence of fracture in the United Kingdom: a retrospective cohort study of 258,696 patients. Osteoarthritis Cartilage. 2020 Dec 21 [Epub ahead of print]. doi: 10.1016/j.joca.2020.12.006. PMID: 33359250. View abstract

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.

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