Both men and women with rheumatoid arthritis, or RA, are known to be at higher risk of fracture than people who do not have RA – but those fractures are thought to occur more frequently in older patients. A new study challenges the conventional wisdom after finding that the risk of fracture among women younger than 50 with RA is as much as five times greater than those in the same age group without RA. 

“We don’t typically see fractures in younger women,” says lead researcher Shreyasee Amin, MD, an associate professor in the division of rheumatology at the Mayo Clinic in Rochester, Minn. “Physicians who treat younger patients with RA, especially women – as well as the patients themselves – need to be aware that fractures can occur at younger ages. Younger patients with RA should be advised to take all the preventive measures, including smoking cessation, daily calcium and vitamin D supplementation and physical exercise.”

For the study, which was presented at the American College of Rheumatology 2011 meeting, researchers reviewed medical records of 1,171 people – 822 women and 349 men – ages 18 and older, and diagnosed with RA between 1955 and 2007. Each person was matched by sex and year of birth with someone from the same community who did not have RA. The researchers looked for any first-time fracture in that time period, as well as fractures at the hip, spine, wrist and upper arm – called osteoporotic fractures because they are typically associated with osteoporosis. Fractures due to cancer or trauma, such as a car accident or other injury, were excluded.