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01-07-2019 | Rheumatology | News | Article

OA patients at increased risk for multiple comorbidities

medwireNews: People with osteoarthritis (OA) are significantly more likely than those without to have multiple comorbidities, particularly stroke, peptic ulcers, and the metabolic syndrome, show results of a systematic review and meta-analysis of observational data.

The analysis, which included over 1.6 million people from 16 countries in 42 studies (27 case‐only and 15 comparative studies) revealed that two-thirds (66%) of patients with OA had at least one other chronic condition, compared with 56% of people without OA.

Among the eight studies that reported the prevalence of comorbidities in people with OA versus that in age- and sex-matched controls, the researchers calculated that the pooled prevalence ratio (PR) for any comorbidity was a significant 1.21 in the patients versus controls, indicating that people with OA had a 21% higher prevalence of comorbidity than those without OA.

However, further analysis showed that the association was dose dependent, such that the PR increased from a nonsignificant 0.73 for one comorbidity to a significant 1.58 and 1.94 for two and three or more comorbidities, respectively.

Among seven system-specific comorbidities analyzed, the risks for upper gastrointestinal disorders (PR=2.36), psychological conditions (PR=1.45), and cardiovascular disease (PR=1.42) were all significantly higher in the people with OA relative to those without. Weaker associations were observed for endocrine and genitourinary conditions, while there was no difference in risk between the two groups for musculoskeletal or respiratory disorders.

The highest risks for specific diseases among people with versus without OA were observed for stroke (PR=2.61), peptic ulcer (PR=2.36), and the metabolic syndrome (PR=1.94).

Writing in Arthritis Care & Research, Weiya Zhang (University of Nottingham, UK) and co-authors caution that their pooled-prevalence findings require “careful interpretation owing to the large heterogeneity” of the data.

However, they add that the purpose of their review was “to identify a signal for future research, not to confirm the prevalence and the risk ratio.”

The researchers comment that “[t]he stronger association of number of comorbidities in OA indicates the existence of the problem of multimorbidity among these people.”

Abd they conclude: “Further research is needed to determine the causality between OA and these common comorbidities to optimise treatment and develop preventative strategies.”

By Laura Cowen

medwireNews is an independent medical news service provided by Springer Healthcare. © 2019 Springer Healthcare part of the Springer Nature group

Arthritis Care Res 2019; doi:10.1002/acr.24008