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  • What We've Learned
Hip Fractures and Rheumatoid Arthritis
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Scientific Study Title:
Hip fracture In patients with Rheumatoid Arthritis: incidence, complications and health services used. (HIRA Study)
Start Date:
  • 2016
End Date:
  • 2024
Research Category
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Why did we do this research?

Hip fractures typically occur as a consequence of osteoporosis, a condition that causes thinning of the bones, and are one of the most serious fall-related injuries. Rheumatoid arthritis is a known risk factor for osteoporosis and fragility fractures, including hip fractures, likely due to chronic inflammation and reduced mobility. However, few recent studies have looked at the extent to which the risk of hip fracture is increased among people with rheumatoid arthritis, compared to people from the general population, since the advent of newer treatments that are more effective at controlling inflammation.

What did we do?

Our objectives were to compare:

  • The risk of hip fractures
  • The risk of death at different time points up to five years after a hip fracture
  • among people with rheumatoid arthritis compared to people without rheumatoid arthritis
  • Using administrative health data from British Columbia, we followed 37,616 people with rheumatoid arthritis and 75,213 people of the same age and sex but without rheumatoid arthritis, focusing on hip fractures and deaths of any cause that occurred up to five years after fractures.

What We Found:

  • We found that people with rheumatoid arthritis had a 28% higher risk of hip fractures compared to people without rheumatoid arthritis. The average age at the time of a fracture was slightly younger in people with rheumatoid arthritis (80 years versus 82 years). The risk is lower than previously reported, likely reflecting better treatment of inflammation and management of osteoporosis and its risk factors.
  • After a hip fracture, the risk of death was similar between people with rheumatoid arthritis and people in the general population.

What are the next steps?

This research highlights the need for implementing fall prevention programs and other osteoporosis and fracture prevention strategies specifically for people with rheumatoid arthritis in order to prevent hip fractures and their long-term complications.

The Research Team

Principal Investigators

  • Allyson Jones, PT, PhD, Affiliate Scientist, Arthritis Research Canada; Professor, Dept Physical Therapy (University of Alberta)
  • Diane Lacaille, MDCM, MHSc, FRCPC, Scientific Director, Arthritis Research Canada (University of British Columbia)

Co-Investigators

  • Pierre Guy, MD MBA, FRCSC, Professor and clinician-scientist, Department of Orthopaedics, Medicine, (University of British Columbia)
  • Hui Xie, BSc, MS, PhD, Research Scientist, Biostatistics, Arthritis Research Canada (Simon Fraser University)

Additional Research Team Members

  • Eric Sayre , PhD, Statistician, Arthritis Research Canada
  • Kai Zhao , MSc, PhD Student Trainee, Arthritis Research Canada

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