to assess the risk of typical osteoporotic fractures among RA com pared with non RA patients. and to evaluate the effects of rheumatoid factor and acute phase reactants on fracture risk among patients phase 3 with RA. Materials and methods Data source We conducted a cohort study using the administrative claims data in the HealthCore Integrated Research Data base for the period 1 January, Inhibitors,Modulators,Libraries 2001 to 30 June, 2008. This database contained longitudinal claims infor mation including medical diagnoses, procedures, hospi talizations, physician visits, and pharmacy dispensings on more than 28 million fully insured subscribers, with medical and pharmacy coverage, to 14 Blue Cross Blue Shield health plans across the USA. Results for outpati ent laboratory tests, including CRP, erythrocyte sedi mentation rate, and RF were available on a subset of beneficiaries.

No information was available on the results of BMD tests or on other radiologic procedures. Personal identifiers were removed from the dataset Inhibitors,Modulators,Libraries before the analysis to protect subject confidentiality. Patient informed consent was, therefore, not required. This study was approved by Brigham and Womens Hospitals Institutional Review Board and Data Use Agreements were in place with HealthCore, Inc. Study cohort Adults aged 18 years or older with at least two visits for RA identified with the International Classification of Diseases, Ninth Revision, Clinical Modification code, 714. xx, were eligible for this study. Subjects who did not have a diagnosis of RA at any time during the entire study period were eligible to be part of the non RA cohort.

Inhibitors,Modulators,Libraries From this eligible non RA cohort, five patients, matched on age and sex were selected for every subject with RA. The follow up period began at the index date, defined as the date Inhibitors,Modulators,Libraries of second RA diagno sis for RA patients and the date of the first medical claim for the non RA patients. We further required all subjects to have at least 12 months of continuous health plan eligibility before the Inhibitors,Modulators,Libraries start of follow up. Subjects were then followed until occurrence of outcomes, loss of eligibility, end of study database, or death. Outcome definitions The definitions of fracture were based on diagnoses and procedure codes contained within the study database. We included hip, wrist, humerus, and pelvis fractures, because these are considered to be typical sites of osteoporotic fracture and can be accurately defined in administrative claims databases. A composite of fractures at these four sites was also considered. Patients were censored at their first fracture in the any osteoporotic fracture analysis. Covariates selleckchem Tipifarnib Variables potentially related to a future fracture were assessed using the data from the 12 months prior to the index date.