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Table 1 Characteristics of 2557 patients with early RA, of whom 352 occurred with fracture

From: Long-term fracture risk in rheumatoid arthritis: impact of early sustained DAS28-remission and restored function, progressive erosive disease, body mass index, autoantibody positivity and glucocorticoids. A cohort study over 10 years

 

Total

(n = 2557)

With fracture

(n = 352)

No fracture

(n = 2205)

P

Age, years

58.1 ± 15.6

66.3 ± 12.5

56.7 ± 15.7

< 0.001

Female sex, %

67.0

77.1

65.4

< 0.001

Current smoking, %

26.8

26.2

26.9

0.805

Ever smoking, %

59.7

60.5

59.5

0.728

Body mass index, kg/m2

25.3 ± 4.2

24.4 ± 3.8

25.5 ± 4.2

< 0.001

 BMI ≤ 20 kg/m2, %

6.4

12.3

5.5

< 0.001

 20 < BMI < 25 kg/m2, %

47.1

46.5

47.1

0.836

 25  BMI < 30 kg/m2, %

34.4

35.3

34.2

0.726

 BMI ≥ 30 kg/m2, %

12.2

5.9

13.2

< 0.001

Prior fractures, %

5.2

9.1

4.6

< 0.001

Osteoporosis, %

32.0

64.7

23.6

< 0.001

Hypertension, %

11.6

14.7

11.1

0.046

Dyslipidemia, %

2.6

2.9

1.3

0.264

Diabetes mellitus, %

5.5

5.7

4.2

0.262

CVD, %

9.5

11.6

9.2

0.153

RA-disease dependent risk factors

Symptom duration at diagnosis, months

6.0 ± 3.2

5.8 ± 3.5

6.1 ± 3.2

0.129

Autoantibody positivity, %

73.2

74.9

72.9

0.461

 RF-positivity, %

61.0

64.3

60.5

0.172

 ACPA-positivity, %

56.8

58.3

56.6

0.596

DAS28

    

 at diagnosis

5.3 ± 1.2

5.5 ± 1.3

5.2 ± 1.2

0.004

 at 6-month

3.5 ± 1.4

3.7 ± 1.4

3.5 ± 1.4

0.006

 at 1-year

3.3 ± 1.4

3.6 ± 1.5

3.3 ± 1.4

0.002

 at 2-year

3.2 ± 1.4

3.3 ± 1.3

3.1 ± 1.4

0.048

DAS28 ≤ 2.6 at 6-month, %

29.6

23.9

30.5

0.019

DAS28 ≤ 2.6 at 1-year, %

34.7

30.7

35.3

0.104

DAS28 ≤ 2.6 at 2-year, %

39.9

33.3

40.9

0.012

DAS28 ≤ 2.6 sustained, %

17.2

11.0

18.2

< 0.001

DAS28 ≤ 3.2 at 6-month, %

44.2

37.5

45.3

0.011

DAS28 ≤ 3.2 at 1-year, %

50.3

44.0

51.2

0.017

DAS28 ≤ 3.2 at 2-year, %

55.5

53.5

55.8

0.443

DAS28 ≤ 3.2 sustained, %

29.6

22.6

30.7

0.003

HAQ

    

 at baseline

1.1 ± 2.1

1.1 ± 0.7

1.1 ± 2.3

0.561

 at 6-month

0.6 ± 0.6

0.7 ± 0.6

0.6 ± 0.6

0.005

 at 1-year

0.6 ± 0.6

0.7 ± 0.6

0.6 ± 0.6

0.014

 at 2-year

0.6 ± 0.6

0.7 ± 0.7

0.6 ± 0.6

< 0.001

HAQ ≤ 0.5 at 6-month, %

52.5

45.8

53.6

0.011

HAQ ≤ 0.5 at 1-year, %

55.3

50.6

56.0

0.075

HAQ ≤ 0.5 at 2-year, %

55.2

45.0

56.8

< 0.001

HAQ ≤ 0.5 sustained, %

39.4

32.0

40.6

0.003

HAQ ≥ 1 at 6-month, %

28.8

36.6

27.6

0.001

HAQ ≥ 1 at 1-year, %

27.4

33.9

26.4

0.006

HAQ ≥ 1 at 2-year, %

26.8

31.7

26.1

0.042

HAQ ≥ 1 sustained, %

12.2

14.8

11.7

0.112

Radiographic RA-disease characteristics

 

SHS score at baseline

1 (0–6)

2 (0–8)

0.5 (0–6)

0.005

Erosion score at baseline

0 (0–1)

0 (0–2)

0 (0–1)

0.454

JSN score at baseline

0 (0–4)

1 (0–6)

0 (0–4)

0.003

SHS score at 2-year

5 (0–17)

8 (1.8–21.8)

5 (0–17)

< 0.001

Erosion score at 2-year

1.0 (0-5-25)

1 (0-6.88)

1 (0–5)

0.041

JSN score at 2-year

3 (0–11)

6 (0–14)

3 (0–11)

< 0.001

SHS progression at 2-year, %

60.4

66.1

59.5

0.036

Erosion progression at 2-year, %

47.1%

55.4

45.8

0.004

JSN progression at 2-year, %

48.9

55.1

47.9

0.024

RA-treatments

Daily prednisolone use, %

    

 at baseline

41.9

45.8

41.2

0.113

 6-month

40.4

43.1

39.9

0.287

 1-year

35.8

40.9

35.0

0.038

 2-year

31.1

36.3

30.2

0.031

Daily prednisolone dosage (only users), mg

    

 at baseline

7.5 (0–10)

7.5 (2.5–10)

7.5 (0–10)

0.869

 6-month

5 (0-7.5)

5 (0-7.5)

5 (0-7.5)

0.768

 1-year

3.75 (0-7.5)

5 (0-7.5)

3.75 (0-7.5)

0.109

 2-year

2.5 (0–5)

2.5 (0–5)

2.5 (0–5)

0.212

AUC of prednisolone dosage over 1 year, mg/month

28.7 ± 37.7

32.5 ± 41.0

28.1 ± 37.1

0.042

AUC of prednisolone dosage over 2 years, mg/month

50.0 ± 66.2

57.0 ± 71.7

48.8 ± 65.2

0.031

Methotrexate over 2 years, %

63.6

64.1

63.6

0.853

Combined cDMARDs over 2 years, %

17.4

17.3

17.4

0.964

Biological agent over 2 years, %

7.0

5.1

7.4

0.125

  1. Values are mean ± SD or median (IQR) or %
  2. p-value (in bold if < 0.5) represents the comparisons between the patients who experienced a fracture and those who did not
  3. BMI, body mass index; CVD, cardiovascular disease; RF, rheumatoid factor; ACPA, anti-citrullinated protein antibodies; DAS28, 28-joint disease activity score; HAQ, Health Assessment Questionnaire; SHS, Sharp-van der Heijde score; JSN, joint space narrowing; AUC, area under the curve; cDMARDs, conventional disease-modifying anti-rheumatic drugs
  4. Sustained: indicated values maintained at the assessments of 6-month, 1-year and 2-year
  5. Progression: progression of a score from baseline ≥ 1 unit