Table 4.
Predictors for both type of osteoporosis treatment and screening in patients with rheumatoid arthritis and osteoarthritis
OPTS, HR (95% CI) | OPTS-ACR, HR (95% CI) | ||||
---|---|---|---|---|---|
|
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Variables | RA patients | OA patients | RA patients | OA patients | |
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Age groups | |||||
| |||||
<40 years (referent) | 1.0 | 1.0 | 1.0 | 1.0 | |
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40–50 years | 1.70 (1.38–2.10) | 1.99 (0.68–5.82) | 2.07 (1.65–2.59) | 1.68 (0.49–5.74) | |
| |||||
51–64 years | 2.25 (1.80–2. 81) | 2.19 (0.74–6.51) | 2.98 (2.35–3.77) | 3.23 (0.94–11.05) | |
| |||||
≥65 years | 2.77 (2.17–3.55) | 2.22 (0.73–6.73) | 3.82 (2.96–4.95) | 3.54 (1.02–12.28) | |
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Gender | |||||
| |||||
Women | |||||
Premenopausal (referent) | 1.0 | 1.0 | 1.0 | 1.0 | |
Postmenopausal | 1.64 (1.39–1.94) | 2.51 (1.41–4.48) | 1.57 (1.33–1.84) | 1.67 (0.93–3.02) | |
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Men | 0.56 (0.46–0.67) | 0.58 (0.31–1.08) | 0.51 (0.42–0.61) | 0.41 (0.21–0.77) | |
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Education level | 1.03 (1.01–1.05) | 1.05 (1.01–1.09) | 1.03 (1.01–1.04) | 1.03 (0.99–1.06) | |
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No insurance | 0.66 (0.51–0.87) | 0.97 (0.54–1.74) | 0.57 (0.44–0.75) | 0.32 (0.14–0.72) | |
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Residency in a rural area | 0.88 (0.81–0.95) | 0.90 (0.74–1.09) | 0.90 (0.83–0.97) | 0.91 (0.77–1.08) | |
| |||||
Disease duration | 1.00 (0.99–1.00) | 1.00 (0.99–1.01) | 1.00 (0.99–1.00) | 1.00 (0.99–1.00) | |
| |||||
Vaccination for influenza | 1.13 (1.05–1.23) | 1.23 (1.03–1.45) | 1.13 (1.05–1.21) | 1.12 (0.97–1.30) | |
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Rheumatic Disease Comorbidity Index | 1.05 (0.99–1.10) | 1.01 (0.92–1. 11) | 1.02 (0.97–1.06) | 1.03 (0.95–1.12) | |
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BMI in categories | |||||
| |||||
<18.5 kg/m2 | 1.01 (0.76–1.34) | 0.83 (0.26–2.64) | 1.12 (0.88–1.42) | 0.24 (0.03–1.75) | |
| |||||
18.5–24.9 kg/m2 (referent) | 1.0 | 1.0 | 1.0 | 1.0 | |
| |||||
25.0–29.9 kg/m2 | 0.85 (0.78–0.94) | 0.78 (0.63–0.96) | 0.88 (0.81–0.96) | 0.83 (0.69–1.00) | |
| |||||
30.0–39.9 kg/m2 | 0.76 (0.69–0.85) | 0.62 (0.50–0.78) | 0.84 (0.76–0.92) | 0.68 (0.55–0.82) | |
| |||||
≥40 kg/m2 | 0.52 (0.44–0.63) | 0.50 (0.36–0.70) | 0.57 (0.49–0.67) | 0.53 (0.39–0.72) | |
| |||||
HAQ | 1.06 (0.99–1.12) | 0.91 (0.81–1.03) | 1.02 (0.97–1.07) | 0.94 (0.85–1.05) | |
| |||||
Glucocorticoid use | |||||
| |||||
Not-using (referent) | 1.0 | 1.0 | 1.0 | 1.0 | |
| |||||
<3 months | 1.34 (1.12–1.60) | 0.99 (0.56–1.76) | 1.34 (1.13–1.57) | 1.14 (0.72–1.33) | |
| |||||
3–12 months | 1.36 (1.18–1.57) | 1.67 (0.96–2.89) | 1.41 (1.24–1.61) | 1.24 (0.72–2.13) | |
| |||||
>12 months | 1.66 (1.49–1.83) | 1.84 (1.05–3.22) | 1.63 (1.49–1.78) | 1.75 (1.09–2.82) | |
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Use of DMARDs | |||||
| |||||
MTX monotherapy (referent) | 1.0 | - | 1.0 | - | |
| |||||
Any TNFi | 1.22 (1.09–1.37) | - | 1.79 (1.07–1.30) | - | |
| |||||
Non-TNFi bDMARDs | 1.38 (1.12–1.69) | - | 1.30 (1.07–1.57) | - | |
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Any others | 1.15 (1.03–1.28) | - | 1.08 (0.98–1.19) | - | |
| |||||
Prior fragility fracture | 1.17 (1.05–1.31) | 1.31 (1.03–1.66) | 1.20 (1.09–1.33) | 1.35 (1.10–1.65) | |
| |||||
Prior diagnosis of OP | 1.52 (1.31–1.76) | 1.52 (1.13–2.05) | 1.49 (1.30–1. 71) | 1.50 (1.14–1.96) | |
| |||||
10-year major osteoporotic fracture risk categories by FRAX | |||||
| |||||
Low (referent) | 1.0 | 1.0 | 1.0 | 1.0 | |
| |||||
Medium | 0.98 (0.88–1.10) | 0.98 (0.78–1.23) | 1.01 (0.92–1.12) | 0.98 (0.80–1.21) | |
| |||||
High | 0.86 (0.74–1.01) | 0.82 (0.59–1.13) | 0.87 (0.76–1.01) | 0.84 (0.62–1.12) |
OPTS=Osteoporosis treatment and screening; OPTS-ACR=ACR-recommended OP treatment and screening; ACR= American College of Rheumatology; HR=Hazard ratio; RA= Rheumatoid arthritis; OA= Osteoarthritis; BMI= Body mass index; HAQ= Health assessment questionnaire; DMARD= Disease modifying antirheumatic drug; MTX=Methotrexate; TNFi= Tumor necrosis factor-α inhibitor; bDMARDs= Biologic disease modifying antirheumatic drugs; OP= Osteoporosis; FRAX= Fracture risk assessment tool.