J Korean Med Sci.  2014 Aug;29(8):1082-1089. 10.3346/jkms.2014.29.8.1082.

The Risk of Osteoporotic Fractures According to the FRAX Model in Korean Patients with Rheumatoid Arthritis

• Lee JH
• Suh YS
• Koh JH
• Jung SM
• Lee JJ
• Kwok SK
• Ju JH
• Park KS
• Park SH

• KMID: 2129602
• DOI: http://doi.org/10.3346/jkms.2014.29.8.1082

Abstract

The aim of the current study is to identify patients without osteoporosis who met the criteria of the fracture risk assessment tool (FRAX) of the National Osteoporosis Foundation (NOF) only. The incidence of fractures was investigated in patients who met only the FRAX criteria of the NOF and patients who presented osteoporosis. Five hundred and forty five patients with rheumatoid arthritis who visited a single center were recruited in Korea. In the follow-up period of median 30 months, the new onset of fractures was investigated. Of 223 patients who have no osteoporosis, 39 (17.4%) satisfied the FRAX criteria for pharmacological intervention. During the follow-up period, 2 new onset fractures occurred in patients who met only the FRAX criteria and 22 new onset fractures did in patients with osteoporosis by bone mineral density. The incidence rate for new onset fractures of patients who met only the FRAX criteria was with 295.93 per 10,000 person-years higher than in the general population with 114.99 per 10,000 person-years. Patients who met the FRAX criteria of the NOF only need pharmacological intervention because their numbers of incidence for new onset fractures are similar to those of patients with osteoporosis by BMD.

Keyword

Arthritis, Rheumatoid; Osteoporosis; Fractures, Bone; BMD; FRAX

MeSH Terms

Age Distribution
Aged
Arthritis, Rheumatoid/diagnosis/*epidemiology
Causality
Comorbidity
Computer Simulation
Female
Humans
Incidence
Male
Middle Aged
*Models, Statistical
Osteoporotic Fractures/diagnosis/*epidemiology
*Proportional Hazards Models
Reproducibility of Results
Republic of Korea/epidemiology
Risk Factors
Sensitivity and Specificity
Sex Distribution

Figure

• 

  Fig. 1 Algorithm of candidates for pharmacological intervention by BMD* of the WHO and FRAX† criteria of the NOF guideline (n=545). Values are expressed as number (percent). *Candidates were defined as patients with osteoporosis by BMD criteria of the WHO. See materials and methods for the definition of osteoporosis by BMD criteria of the WHO; †10-yr probability of ≥ 20% for major osteoporotic fracture or ≥ 3% for hip fracture. BMD, bone mineral density; WHO, World Health Organization; FRAX, fracture risk assessment tool; NOF, National Osteoporosis Foundation.

• 

  Fig. 2 Subtrochanteric fracture of femur without trauma in a patient with a new onset fracture. The figure shows a subtrochanteric fracture in a 66-yr-old woman with a history of 8 yr risedronate treatment.

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