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Archives of Osteoporosis
Published in: Archives of Osteoporosis 1/2023

01-12-2023 | Osteoporosis | Original Article

Risk factors predicting the ‘time to first fracture’ and its association with imminent fractures: a substudy of the FRISBEE cohort

Authors: Jeroen M. K. de Filette, Alexia Charles, Amélie Bellanger, Laura Iconaru, Felicia Baleanu, Murielle Surquin, Jean-Jacques Body, Pierre Bergmann

Published in: Archives of Osteoporosis | Issue 1/2023

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Abstract

Summary

Only previous glucocorticoid use and rheumatoid arthritis were predictors of an early fracture (< 2 years after inclusion). A shorter ‘time to first fracture’ was not an independent clinical risk factor for imminent fractures.

Purpose

Risk factors for fragility fractures independent of BMD were assessed in several prediction models. However, predictors of a shorter 'time to first fracture' and its impact on imminent fractures are unknown.

Methods

We studied the concept of ‘time to first fracture’ in the FRISBEE (“Fracture RIsk Brussels Epidemiological Enquiry”) cohort (3560 postmenopausal women). Validated fractures were divided into 3 groups: first fracture < 2 years, 2–5 years, and > 5 years after inclusion. Factors associated with first fracture risk were evaluated with uni- and multivariate analyses using Cox modeling. We examined ‘time to first fracture’ as a risk factor for imminent fractures in untreated subjects and in those receiving pharmacological treatment.

Results

Classical risk factors (age, prior fracture, fall history and low BMD) were associated with first fracture in all groups. Previous glucocorticoids and rheumatoid arthritis (RA) were predictors for fracture < 2 years. Imminent fractures were similar in subjects with or without osteoporosis treatment, despite a higher estimated 10-year risk of fragility fracture in those treated, suggesting that treatment is efficient. 'Time to first fracture' was not an independent risk factor for imminent fractures.

Conclusion

Among the risk factors considered, previous glucocorticoid use and RA were predictors for early fracture, consistent with the concept of very high risk. The ‘time to first validated fracture’ was not an independent risk factor for imminent fractures. Patients with a first osteoporotic fracture should thus be considered at very high risk for re-fracture, independent of the 'time to first fracture'.
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Metadata
Title
Risk factors predicting the ‘time to first fracture’ and its association with imminent fractures: a substudy of the FRISBEE cohort
Authors
Jeroen M. K. de Filette
Alexia Charles
Amélie Bellanger
Laura Iconaru
Felicia Baleanu
Murielle Surquin
Jean-Jacques Body
Pierre Bergmann
Publication date
01-12-2023
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2023
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-023-01296-w

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