Dr. Curtis has received consultancies, speaking fees, and honoraria from Roche, UCB (more than $10,000 each) Proctor & Gamble, Amgen, Centocor, CORRONA, Novartis, Merck, and Eli Lilly (less than $10,000 each).
Skeletal health among African Americans with recent-onset rheumatoid arthritis
Article first published online: 29 SEP 2009
Copyright © 2009 by the American College of Rheumatology
Arthritis Care & Research
Volume 61, Issue 10, pages 1379–1386, 15 October 2009
How to Cite
Curtis, J. R., Arora, T., Donaldson, M., Alarcón, G. S., Callahan, L. F., Moreland, L. W., Bridges, S. L. and Mikuls, T. R. (2009), Skeletal health among African Americans with recent-onset rheumatoid arthritis. Arthritis & Rheumatism, 61: 1379–1386. doi: 10.1002/art.24841
- Issue published online: 29 SEP 2009
- Article first published online: 29 SEP 2009
- Manuscript Accepted: 18 MAY 2009
- Manuscript Received: 8 DEC 2008
- NIH. Grant Numbers: N01-AR-02247, M01-RR-00032, 1-K23-AR053351-01A1, N01-AR-6-2278
- University of Alabama General Clinical Research Center
- National Institute of Arthritis and Musculoskeletal and Skin Diseases of the NIH. Grant Number: AR053351
- Arthritis Foundation
- National Institute of Arthritis and Musculoskeletal and Skin Diseases of the NIH. Grant Numbers: R03-AR-054539, K23-AR-050004
- Veterans Affairs Merit Grant
- Arthritis Foundation (National and Nebraska Chapters)
African Americans with rheumatoid arthritis (RA) may be at increased fracture risk. We applied the World Health Organization (WHO) Fracture Risk Assessment Tool (FRAX) and National Osteoporosis Foundation (NOF) guidelines to a cohort of African Americans with early RA to identify which patients were recommended for osteoporosis treatment.
Risk factors and bone mineral density (BMD) were assessed in a cohort of African Americans with RA. The WHO FRAX tool estimated 10-year fracture risk. Patients were risk stratified using FRAX without BMD to identify which individuals might be most efficiently targeted for BMD testing.
Participants (n = 324) had a mean age of 51 years and included 81% women. There were no associations of RA disease characteristics with BMD. The proportion of patients recommended for osteoporosis treatment varied from 3–86%, depending on age and body mass index (BMI). Ten-year fracture risk calculated with BMI only was generally the same or higher than fracture risk calculated with BMD; adding BMD data provided the most incremental value to risk assessment in patients 55–69 years of age with low/normal BMI, and in those ≥70 years of age with BMI ≥30 kg/m2.
A high proportion of African Americans with RA were recommended for treatment under the 2008 NOF guidelines. FRAX without BMD identified low-risk patients accurately. Systematic application of FRAX to screen high-risk groups such as patients with RA may be used to target individuals for BMD testing and reduce the use of unnecessary tests and treatments.