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Incidence and risk factors for vertebral fracture in rheumatoid arthritis: an update meta-analysis

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Abstract

Objectives

This study was conducted to investigate the prevalence of vertebral fracture (VF) and its risk in patients with rheumatoid arthritis (RA) as compared to healthy individuals, and to explore the underlying risk factors.

Methods

The electronic databases of PubMed, EMBASE, and the Cochrane Library were applied to search for the relevant literatures, which reported the prevalence of VF in both RA patients and healthy controls (up to Mar 31, 2021). The non-weighted prevalence of VF, pooled estimates of odds ratio (OR), and its 95% confidence intervals (CI) were calculated with the use of random-effects model; between-study heterogeneity was evaluated by Cochrane Q statistic, then was quantified with I2. Publication bias was evaluated using Egger’s linear regression test.

Results

A number of 867 literatures were identified after searching for online databases, based on the inclusion and exclusion criteria, 11 eligible studies, which comprising 3805 RA patients and 59,517 healthy participants, were finally incorporated in meta-analysis. The results showed that RA patients had an increased prevalence of VF (20.29 vs 8.63%), and an elevated risk for VF (OR = 3.04, 95% CI 1.97–4.71) as compared to healthy population. Additional subgroup analysis suggested that age, body mass index (BMI), disease activity, and drug therapy might be associated with risk of VF in RA.

Conclusions

Overall, our study demonstrated an increased risk of VF in patients with RA, suggesting that age, race, BMI, disease activity, and drug therapy may be represented as risk factors contributing to the occurrence of VF in RA.

Key Points

• RA patients had the increased prevalence and risk of vertebral fracture (VF) as compared to healthy population.

• Age, race, BMI, disease activity, and drug therapy might be associated with VF in RA.

• Our findings would be helpful for the early evaluation of RA patients with high VF risk.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Author notes

  1. Yang Liu and Jun Jiang contributed equally contributed to this work

Authors and Affiliations

  1. The First Department of Orthopedics, Xinyu People’s Hospital, 369 Xinxin Bei Road, Xinyu, 338000, Jiangxi, People’s Republic of China

    Yang Liu, Minmin Mo & Kailong Yu

  2. The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, Liaoning, 116011, People’s Republic of China

    Jun Jiang & Xiaohong Sun

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  1. Yang Liu
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  2. Jun Jiang
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  3. Minmin Mo
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Contributions

K. Y. conceived of the presented idea. Y. L. developed the theory and performed the computations. J. J verified the analytical methods. All authors discussed the results and contributed to the final manuscript.

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Correspondence to Xiaohong Sun or Kailong Yu.

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Liu, Y., Jiang, J., Mo, M. et al. Incidence and risk factors for vertebral fracture in rheumatoid arthritis: an update meta-analysis. Clin Rheumatol 41, 1313–1322 (2022). https://doi.org/10.1007/s10067-021-06046-2

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