Osteoarthritis more than doubles risk for multiple comorbidities
Individuals with osteoarthritis have a 2.5-times greater risk for having three or more other chronic conditions, including stroke and peptic ulcers, compared with those without osteoarthritis, according to findings published in Arthritis Care & Research.
“A systematic review on OA reported worsening of pain and decline in functional activities among people due to the presence of other chronic conditions,” Subhashisa Swain, MPH, of the University of Nottingham in the UK, and colleagues wrote. “Clinically, comorbidities in OA create greater challenges for management. The number and pattern of different comorbid conditions determine the severity and burden in multimorbid patients. However, except for shared risk factors such as aging and obesity, little is known about biological plausibility to explain concurrence of OA and associated comorbidities.”
To review the current literature regarding comorbidities among patients with OA, compared with those without the disease, Swain and colleagues searched Medline, PubMed, Embase and Scopus databases for studies published between Jan. 1, 1995, and Dec. 31, 2017. The researchers also searched “comorbidity in OA” in Google Scholar. Specifically, the researchers limited their search to studies of OA only, as well as those that compared patients with OA with control participants without the condition.
The initial literature review yielded 70,014 articles, of which 1,091 remained after discarding duplicates and irrelevant studies. Further review confirmed 56 relevant articles, of which 42 studies, from 16 countries, met the eligibility criteria. Swain and colleagues determined risk for bias and study quality using the NewcastleOttawa Scale.
According to the researchers, the pool prevalence of any comorbidity was 67% among patients with OA (95% CI, 57%74%), compared with 56% in those without OA (95% CI, 44%-68%). Meanwhile, the pooled prevalence ratio for any comorbidity was 1.21 (95% CI, 1.021.45). The prevalence ratio (PR) increased from 0.73 for one comorbidity (95% CI, 0.431.25), to 1.58 for two (95% CI, 1.032.42), as well as to 1.94 for three or more (95% CI, 1.45 2.59).
Comorbidities most associated with OA were stroke (PR = 2.61; 95% CI, 2.133.21), peptic ulcer (PR = 2.36; 95% CI, 1.713.27) and metabolic syndrome (PR = 1.94; 95% CI, 1.213.12).
“People with OA are 1.2 times more likely to have any comorbidity than non-OA controls and 2.5 times more likely to have three or more comorbidities,” Swain and colleagues wrote. “The comorbidities with the highest increase in risk are stroke, peptic ulcer, hypertension and depression. Further research is needed to determine the causality between OA and these common comorbidities to optimize treatment and develop preventative strategies.” – by Jason Laday
Disclosure: The researchers report no relevant financial disclosures.