Elevated Fracture Risk in Lupus Save

A Medicaid study of lupus (SLE) patients finds that fracture risks are elevated in low‐income SLE and lupus nephritis patients compared to those without SLE.

A cohort study matched Medicaid SLE patients and age‐ and sex‐matched non‐SLE comparators to study the primary outcome of fracture of the pelvis, wrist, hip, or humerus.

Researchers compared 47,709 SLE patients (20% with lupus nephritis) with matched 190,836 non‐SLE comparators. Patients had a mean age of 41.4 years and 93% were female.  Key findings included:

• Fracture incidence rate (IR) was highest among SLE patients with nephritis (4.60/1,000 person‐years).
• SLE patients had two‐fold higher fracture risk than matched comparators (HR 2.09 [95% CI 1.85, 2.37]).
• Lupus nephritis patients had the greatest fracture risks versus matched comparators (HR 3.06 [2.24, 4.17]),
• Lupus nephritis patients had 1.6 times higher fracture risk than SLE patients without nephritis (HR 1.58 [1.20, 2.07]).
• Adjustment for glucocorticoid use and comorbidities slightly attenuated risks.

Fracture risks were elevated in SLE patients, particularly those with lupus nephritis, even after adjusting for baseline glucocorticoids and comorbidities.