Positive RF and elevated acute phase reactants were associated, a

Positive RF and elevated acute phase reactants were associated, although not statistically significant, with an increased http://www.selleckchem.com/products/Bicalutamide(Casodex).html fracture risk among the patients with RA after multivari able adjustment in Cox models. Prior use of oral gluco corticoids also increased risk of osteoporotic fracture among the patients in this subgroup analysis. Discussion Osteoporotic fractures are more common in patients with RA than the general population. We studied the IRs of osteoporotic fracture of the humerus, wrist, hip, and pelvis in a cohort of 47,034 RA patients using claims data. The IRs of fracture were 1. 5 times higher among patients with RA compared with non RA patients Inhibitors,Modulators,Libraries regard less of age, sex, or anatomic sites. This association between RA and fracture weakened after multivariable adjustment for known risk factors of osteoporosis includ ing oral glucocorticoid use.

Chronic inflammation has been recently recognized as a potential risk factor for osteoporosis Inhibitors,Modulators,Libraries and fracture. The Health Aging and Body Inhibitors,Modulators,Libraries Composition Study showed that elevated inflammatory markers, such as IL 2, IL 6, CRP, and TNF a, were associated with osteoporotic frac ture. In a study of 74 post menopausal women with RA, high disease activity, measured by high CRP levels and ESR, and an elevated IL 6 were associated with an increase in periarticular as well as systemic bone resorp tion. We performed subgroup analyses adjusted for either RF or acute phase reactants, in which the activity of RA or inflammation can be better, but not completely, taken into consideration.

Both RF positivity and elevated acute Inhibitors,Modulators,Libraries phase reactant levels increased the risk of fracture but the association was not statistically significant. The association between oral glucocorticoid use and fracture risk remained increased among the subgroup of RA patients in whom these laboratory data were available. Nonetheless, our subgroup analyses might not have suffi cient power to assess the independent association between these potential risk factors and fracture risks. The recently developed World Health Organization fracture risk assessment tool, FRAX, computes the 10 year probability of hip fracture or a major osteoporotic fracture, based on individual patient models that inte grate the risks associated with BMD at the femoral neck as well as clinical risk factors such as age, sex, smoking status, use of glucocorticoids, history of osteoporosis and prior fall, and RA.

Fracture risk related to RA independent of BMD incorporated in this tool is higher than our results. This difference is prob ably associated with baseline Inhibitors,Modulators,Libraries characteristics of study population and degree of confounding adjustment. Several strengths of this study are worth noting. We examined selleckchem a very large cohort of RA and non RA patients in a population that is representative of the US commercially insured population.

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