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The following is a summary of “Association of Therapies for Axial Spondyloarthritis on the Risk of Hip and Spine Fractures,” published in the December 2024 issue of Rheumatology by Driscoll et al.
Axial spondyloarthritis (axSpA) increases fracture risk, likely due to chronic inflammation. This elevated risk is higher compared to the general population.
Researchers conducted a retrospective study to assess the impact of tumor necrosis factor inhibitors (TNFi) and non-biologic conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) on hip and spine fractures in axSpA, comparing these treatments to nonsteroidal anti-inflammatory drugs (NSAIDs) in reducing fracture risk.
They conducted a nested case-control study using 2006-2021 data from the Merative™ MarketScan® Database, including adults aged 18-65 with ≥1 inpatient or ≥2 outpatient axSpA diagnoses. The primary outcome was hip/spine fracture, defined by ICD-9 or 10 codes. Up to 10 controls were selected for each fracture case. Medication exposure (TNFi, csDMARDs, NSAIDs, or none) was assessed using pharmacy claims. Fracture risk was evaluated with unconditional logistic regression, adjusted for confounders.
The results showed that among 13,519 individuals with axSpA, those on TNFi had 29% lower odds of fracture than those on NSAIDs (OR 0.71, 95% CI 0.59-0.85). Similar findings were observed in the fully adjusted model (OR 0.75, 95% CI 0.62-0.91) and when stratified by sex.
Investigators found that TNFi reduced fracture risk in axSpA, highlighting its potential to alleviate associated comorbidities.
Source: acrjournals.onlinelibrary.wiley.com/doi/abs/10.1002/art.43082
