Incidence rate and factors associated with fractures among Medicare beneficiaries with ankylosing spondylitis in the United States
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Incidence rate and factors associated with fractures among Medicare beneficiaries with ankylosing spondylitis in the United States. / Stovall, Rachael; Kersey, Emma; Li, Jing; Baker, Rahaf; Anastasiou, Christine; Palmowski, Andriko; Schmajuk, Gabriela; Gensler, Lianne; Yazdany, Jinoos.
I: Arthritis Care & Research, Bind 76, Nr. 2, 2024, s. 265-273.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Incidence rate and factors associated with fractures among Medicare beneficiaries with ankylosing spondylitis in the United States
AU - Stovall, Rachael
AU - Kersey, Emma
AU - Li, Jing
AU - Baker, Rahaf
AU - Anastasiou, Christine
AU - Palmowski, Andriko
AU - Schmajuk, Gabriela
AU - Gensler, Lianne
AU - Yazdany, Jinoos
N1 - This article is protected by copyright. All rights reserved.
PY - 2024
Y1 - 2024
N2 - OBJECTIVE: We evaluated the incidence rate and factors associated with fractures among adults with ankylosing spondylitis (AS).METHODS: We performed a retrospective cohort study with data from the Rheumatology Informatics System for Effectiveness (RISE) registry linked to Medicare claims from 2016-2018. Patients were required to have two AS ICD codes, ≥30 days apart, and a subsequent Medicare claim. Then, one year of baseline characteristics were included, after which patients were observed for fractures. First, we calculated the incidence rate of fractures. Second, we constructed logistic regression models to identify factors associated with fracture, including age, sex, race/ethnicity, body mass index, Medicare/Medicaid dual-eligibility, area deprivation index, Charlson comorbidity index, smoking status, osteoporosis, historical fracture, and use of osteoporosis treatment, glucocorticoids, and opioids.RESULTS: We identified 1,426 adults with prevalent AS. Mean (SD) age was 69.4 years (9.8), 44.3% were female, and 77.3% were non-Hispanic White. Fractures occurred in 197 adults with AS. The overall incidence rate of fractures was 76.7 (95% CI 66.4-88.6) per 1,000 person-years. Older age (OR 2.8, 95% CI 1.39-5.65), historical fracture (OR 5.24, 95% CI 3.44-7.99), and use of >30 mg morphine equivalent (OR 1.86, 95% CI 1.08-3.19) conferred increased odds of fracture.CONCLUSIONS: In this large sample of Medicare beneficiaries with AS, increasing age, historical fracture, and use of opioids had a higher odds of fracture. Men and women were equally likely to have a fracture. Because opioid use was associated with fracture in AS, this high-risk population should be considered for interventions to mitigate risk. This article is protected by copyright. All rights reserved.
AB - OBJECTIVE: We evaluated the incidence rate and factors associated with fractures among adults with ankylosing spondylitis (AS).METHODS: We performed a retrospective cohort study with data from the Rheumatology Informatics System for Effectiveness (RISE) registry linked to Medicare claims from 2016-2018. Patients were required to have two AS ICD codes, ≥30 days apart, and a subsequent Medicare claim. Then, one year of baseline characteristics were included, after which patients were observed for fractures. First, we calculated the incidence rate of fractures. Second, we constructed logistic regression models to identify factors associated with fracture, including age, sex, race/ethnicity, body mass index, Medicare/Medicaid dual-eligibility, area deprivation index, Charlson comorbidity index, smoking status, osteoporosis, historical fracture, and use of osteoporosis treatment, glucocorticoids, and opioids.RESULTS: We identified 1,426 adults with prevalent AS. Mean (SD) age was 69.4 years (9.8), 44.3% were female, and 77.3% were non-Hispanic White. Fractures occurred in 197 adults with AS. The overall incidence rate of fractures was 76.7 (95% CI 66.4-88.6) per 1,000 person-years. Older age (OR 2.8, 95% CI 1.39-5.65), historical fracture (OR 5.24, 95% CI 3.44-7.99), and use of >30 mg morphine equivalent (OR 1.86, 95% CI 1.08-3.19) conferred increased odds of fracture.CONCLUSIONS: In this large sample of Medicare beneficiaries with AS, increasing age, historical fracture, and use of opioids had a higher odds of fracture. Men and women were equally likely to have a fracture. Because opioid use was associated with fracture in AS, this high-risk population should be considered for interventions to mitigate risk. This article is protected by copyright. All rights reserved.
U2 - 10.1002/acr.25219
DO - 10.1002/acr.25219
M3 - Journal article
C2 - 37605840
VL - 76
SP - 265
EP - 273
JO - Arthritis Care & Research
JF - Arthritis Care & Research
SN - 2151-464X
IS - 2
ER -
ID: 365923923