TOPLINE:

Postmenopausal women with erosive hand osteoarthritis (OA) had nearly double the risk for incident osteoporotic fractures than those without hand OA, and this increased risk was not explained by standard changes in bone mineral density (BMD).

METHODOLOGY:

• Researchers used data from a prospective cohort (QUALYOR) to assess whether erosive hand OA was linked to bone loss and osteoporotic fractures in postmenopausal women.
• They included 1180 postmenopausal women with osteopenia (mean age, 71.7 years) from France who were enrolled between 2010 and 2013 and assessed hand OA at the 6-year follow-up visit.
• Hand radiographs and a symptom questionnaire were used to classify women on the basis of OA status; 30.8% of women had no hand OA, 28.4% had radiographic hand OA without symptoms, 28.8% had symptomatic hand OA without erosions, and 11.9% had erosive hand OA.
• BMD at the lumbar spine, femoral neck, and total hip was measured using DEXA, and incident osteoporotic fractures were medically confirmed.
• Women were followed up for a mean of 4.6 years after the assessment of hand OA.

TAKEAWAY:

• Overall, 131 women (11.1%) experienced 166 new osteoporotic fractures during follow‑up.
• Women with erosive hand OA had a higher age-standardised incident fracture rate than those without hand OA (58.5 vs 30.3 per 1000 patient-years; P < .05).
• Erosive hand OA was associated with a 1.9-fold higher risk for incident osteoporotic fractures than no hand OA after adjusting for key factors (P = .031). The association persisted after adjusting for baseline and longitudinal changes in hip BMD.
• BMD at the lumbar spine increased significantly in women with erosive hand OA, whereas it decreased in those without hand OA. BMD at the femoral neck and total hip decreased over time in all groups, with no significant differences according to hand OA status.

IN PRACTICE:

"[The] results highlight erosive hand osteoarthritis as an independent contributor to fracture risk, reinforcing the importance of including it in predictive models and motivating further research into the molecular and physiological determinants of this association," the authors of the study wrote.

SOURCE:

The study was led by Maxime Auroux, INSERM U1033, Lyon, France. It was published online on June 13, 2026, in Osteoarthritis and Cartilage.

LIMITATIONS:

Few fractures occurred in women with erosive hand OA, which reduced the accuracy of the estimates. Hand OA was assessed only once at year 6; thus, researchers could not differentiate between incident and prevalent disease or assess disease duration. The findings came only from postmenopausal women, which might differ in men.

DISCLOSURES:

No funding sources were provided for this study. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.