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Do biological disease-modifying antirheumatic drugs reduce the spinal fracture risk related to ankylosing spondylitis?: A longitudinal multiregistry matched cohort study
Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden.
Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden.
University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Psychology.
2017 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, no 12, article id e016548Article in journal (Refereed) Published
Abstract [en]

Objectives: Ankylosing spondylitis (AS) is associated with an increased spinal fracture risk due to the loss of elasticity in spinal motion segments. With the introduction of biological disease-modifying antirheumatic drug (bDMARD) treatment for AS, the individual course of the disease has been ameliorated. This study aims to examine the association of bDMARD treatment and risk of spinal fracture.

Design: Longitudinal population-based multiregistry observational matched cohort study.

Setting: Swedish Patient Registry 1987-2014 and Swedish Prescribed Drugs Registry 2005-2014.

Participants: Included were patients ≥18 years of age receiving treatment at a healthcare facility for the primary diagnosis of AS. About 1352 patients received more than one prescription of bDMARD from 2005 to 2014. An untreated control group was created by propensity score matching for age, sex, comorbidity, antirheumatic prescriptions and years with AS (n=1352).

Main Outcome Measures: Spinal fracture-free survival.

Results: No bDMARD treatment-related effect on spinal fracture-free survival was observed in the matched cohorts. Male gender (HR=2.54, 95% CI 1.48 to 4.36) and Charlson Comorbidity Index score (HR=3.02, 95% CI 1.59 to 5.75) contributed significantly to spinal fracture risk.

Conclusion: bDMARD had no medium-term effect on the spinal fracture-free survival in patients with AS.

Trial Registration Number: NCT02840695

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd , 2017. Vol. 7, no 12, article id e016548
Keywords [en]
ankylosing spondylitis, fracture, rheumatology, spine
National Category
Surgery
Identifiers
URN: urn:nbn:se:hig:diva-25977DOI: 10.1136/bmjopen-2017-016548ISI: 000423826700027Scopus ID: 2-s2.0-85053120396OAI: oai:DiVA.org:hig-25977DiVA, id: diva2:1172442
Note

Funding agency:

- Medtronic  

- DePuy Synthes 

Available from: 2018-01-10 Created: 2018-01-10 Last updated: 2018-09-24Bibliographically approved

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Willander, Johan

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