Risk factors associated with the occurrence of proximal humerus fractures in patients with rheumatoid arthritis: a custom strategy for preventing proximal humerus fractures

Kensuke Ochi, Takefumi Furuya, Mina Ishibashi, Makiko Watanabe, Katsunori Ikari, Atsuo Taniguchi, Hisashi Yamanaka, Shigeki Momohara

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

To our knowledge, no prior report focused on the risk factors for proximal humerus fractures in patients with rheumatoid arthritis. The purpose of this study was to evaluate the association between potential risk factors and the occurrence of proximal humerus fractures in patients with rheumatoid arthritis. A total of 11,907 patients with rheumatoid arthritis were enrolled in our observational cohort rheumatoid arthritis study between 2000 and 2012. Self-reported proximal humerus fractures were verified using the patients’ medical records. Cox proportional hazard models were used to analyze the independent contribution of risk factors to the occurrence of proximal humerus fractures. During follow-up (mean 5.6 years), 92 proximal humerus fractures were verified in 91 patients. Multivariate Cox regression analyses estimated that the hazard ratios of sustaining a proximal humerus fracture were 1.37 for every 10-year increase in age [95 % confidence interval (CI) 1.10–1.70; P < 0.01], 1.95 for increases in serum C-reactive protein levels (mg/100 mL; 95 % CI 1.15–3.34; P < 0.05), 2.13 for a history of fractures (95 % CI 1.34–3.40; P < 0.01), 1.07 for the daily prednisolone dose (per mg; 95 % CI 1.01–1.13; P < 0.05), and 1.97 for oral bisphosphonate use (95 % CI 1.20–3.23; P < 0.01). Better control of rheumatoid arthritis with a smaller daily prednisolone dose in elderly patients with a history of fractures may be important for preventing proximal humerus fractures.

Original languageEnglish
Pages (from-to)213-219
Number of pages7
JournalRheumatology International
Volume36
Issue number2
DOIs
Publication statusPublished - 2016 Feb 1

Keywords

  • Fracture
  • Glucocorticoid
  • Proximal humerus fracture
  • Rheumatoid arthritis
  • Risk factors

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology

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