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Trends in fractures in patients with spondyloarthritis: a nationwide population-based study (TREND-EspA study)

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Abstract

Summary

Our aim was to analyze trends in fracture rates in SpA patients over an extended time period. Only an increase of axial fractures, more specifically vertebral fractures, is observed in SpA.

Purpose

To analyze fracture incidence and trend in patients with spondyloarthritis (SpA) over an extended time period.

Methods

Retrospective observational population-based study with matched cohorts. Data from the Minimum Basic Data Set (MBDS) of Spain were reviewed. All SpA patient hospitalizations reported from 1999 to 2015 (SpA cohort) were analyzed. A control cohort (non-SpA cohort) matched by age, sex, region, and year of hospitalization was recruited. The age and sex-adjusted crude incidence rate was calculated for any fractures (axial and peripheral). Generalized linear models (GLM) were used for trend analysis. Association between fracture type and SpA (and its subtypes) was assessed using unconditional logistic regression models.

Results

In the SpA cohort, the age and sex-adjusted rates per 100,000 inhabitants/year of total fracture and different types of fracture were 45.72 any fractures, 17.64 axial, and 28.02 peripheral; 29.42 osteoporotic (12.67 vertebra, 12.29 hip, 1.50 pelvis, 1.82 humerus and 2.09 radius). In the non-SpA cohort, they were 65.79 any, 12.08 axial, 51.52 peripheral; 31.17 osteoporotic (4.94 vertebra, 16.15 hip, 2.29 pelvis, 3.64 humerus, 5.38 radius). Between 1999 and 2015, the trend in incidence rate for total fracture and different types of fracture increased similarly for both cohorts. In the SpA cohort, an increase of axial fractures was found (AOR 1.444; 95%CI 1.297–1.609), and specifically of vertebral fractures (AOR 2.440; 95%CI 2.097–2.839). Other types of fractures did not increase.

Conclusions

Only an increase of axial fractures, more specifically vertebral fractures, is observed in SpA. Trend in incidence is similar in both cohorts.

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Data availability

The databases used for this study can be made available for review upon request to rmazzucchelli@fhalcorcon.es.

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Acknowledgements

The authors thank the staff of the Research Unit of the Spanish Society of Rheumatology (SER) for their support in the translation of this manuscript.

To my good friend Caligula who faithfully accompanies me in my research work.

Funding

This study was supported by a research grant from Pfizer (Pfizer 61029829) to RM.

Author information

Authors and Affiliations

  1. Rheumatology Unit, Hospital Universitario Fundación Alcorcon, Calle Budapest, 1, Alcorcon, 28922, Madrid, Spain

    Ramon Mazzucchelli & Raquel Almodovar

  2. Department of Preventive Medicine and Public Health, Rey Juan Carlos University, Madrid, Spain

    Ramon Mazzucchelli & Raquel Almodovar

  3. Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de America, Madrid, Spain

    Elisa Dieguez-Costa

  4. Centro de Salud La Rivota, 29922, Alcorcon, Madrid, Spain

    Natalia Crespi Villarias

  5. Department of Clinical Research, Hospital Universitario Fundación Alcorcón, 28922, Alcorcón, Madrid, Spain

    Elia Pérez-Fernandez

  6. Rheumatology Department, Hospital Universitario La Princesa, 28006, Madrid, Spain

    Alberto García-Vadillo

Authors
  1. Ramon Mazzucchelli
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  2. Raquel Almodovar
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  3. Elisa Dieguez-Costa
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  6. Alberto García-Vadillo
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Contributions

RM and NCV designed the research. EPF, RM and NCV. RM, NCV, EDC, RA, and AGV wrote the paper.

Corresponding author

Correspondence to Ramon Mazzucchelli.

Ethics declarations

Ethics approval

The Hospital Fundación Alcorcon’s Ethics Committee (ref 18/135) evaluated the present project and approved it on December 18th, 2018.

Conflicts of interest

Ramón Mazzucchelli received research grants from Pfizer, Roche, and Amgen due to different projects in the past. The rest of authors have no conflicts of interest to declare. The study is based on data obtained from the Minimum Basic Data Set (MBDS) of Spain provided by its Ministry of Health and Welfare. The interpretation and conclusions do not necessarily represent those of this Ministry.

Statement of human and animal rights

This article does not contain any studies involving human participants or animals that were performed by the authors. For this type of study, formal consent was therefore not required.

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Mazzucchelli, R., Almodovar, R., Dieguez-Costa, E. et al. Trends in fractures in patients with spondyloarthritis: a nationwide population-based study (TREND-EspA study) . Osteoporos Int 33, 149–159 (2022). https://doi.org/10.1007/s00198-021-06079-y

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  • DOI: https://doi.org/10.1007/s00198-021-06079-y

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