You are here

  • Home
  • Archive
  • Volume 7, Issue 12
  • Do biological disease-modifying antirheumatic drugs reduce the spinal fracture risk related to ankylosing spondylitis? A longitudinal multiregistry matched cohort study

Article Text

Article menu

Download PDFPDF

XML
Rheumatology
Research
Do biological disease-modifying antirheumatic drugs reduce the spinal fracture risk related to ankylosing spondylitis? A longitudinal multiregistry matched cohort study
  1. Yohan Robinson1,
  2. Claes Olerud1,
  3. Johan Willander2
  1. 1 Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden
  2. 2 Department of Psychology, Gävle University College, Gävle, Sweden
  1. Correspondence to Dr Yohan Robinson; yohan.robinson{at}surgsci.uu.se

Abstract

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; Post-results.

  • rheumatology
  • ankylosing spondylitis
  • spine
  • fracture

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2017-016548

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors YR: designed the study, analysed the data and wrote the manuscript. CO: supervised the study and revised the final manuscript. JW: critically revised the statistical methods.

    • Competing interests YR and CO have been paid for developing and delivering educational presentations for Medtronic and DePuy Synthes.

    • Ethics approval Uppsala Ethical Review Board (no: 2015/147).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement The Swedish National Patient Registry is hosted by the Swedish National Board of Health and Welfare. Data collection for the Swedish Prescribed Drugs Registry (PDR) is administered by the National Corporation of Swedish Pharmacies. National registry data is available to researchers from the Swedish National Board of Health and Welfare (http://www.socialstyrelsen.se/statistics) after institutional review board approval.