Hip osteoarthritis burden increasing 'in almost all countries'
The burden of hip osteoarthritis has increased globally in the past 30 years, with incidence and disability-adjusted life years rising “in nearly all countries,” according to data published in Arthritis Research & Therapy.
“In recent years, the burden of osteoarthritis by region and country has been reported in several review papers,” Ming Fu, of Heilongjiang Provincial Hospital, at the Harbin Institute of Technology, in China, and colleagues wrote. “One study reported the global burden of osteoarthritis (knee and hip) for 1990 to 2017 using the World Health Organization Burden of Diseases Database, but it did not especially focus on hip osteoarthritis or on the association of hip osteoarthritis burden with country, region, sex, age, or social development index (SDI).”
They added: “The Global Burden of Disease Study (GBD) 2019 is a multinational collaborative research study that estimates the burden of 354 human diseases and injuries, including hip osteoarthritis, in 204 countries and territories worldwide, and provides a public dataset for use in investigations of the trends in the distribution of hip osteoarthritis.”
To analyze the epidemiological patterns of hip OA from 1990 to 2019, Fu and colleagues conducted subgroup analyses of data from the GBD 2019. Analyses were conducted by region, sex, age and sociodemographic index (SDI). The researchers determined age-standardized rates of incidence and disability-adjusted life years (DALYs) for OA from 21 regions across a total of 204 countries and territories. These countries were additionally grouped into five SDI categories: Low, low-middle, middle, high-middle and high.
A total of nine countries and territories — the Cook Islands, Monaco, San Marino, Nauru, Niue, Palau, Saint Kitts and Nevis, Tokelau, and Tuvalu — were newly added to the GBD 2019. The researchers calculated estimated annual percentage changes (EAPCs) of age standardized rates, adjusting for studies reporting hip OA identified by radiography alone, by self-reported physician diagnosis with pain, by self-reported physician diagnosis with no mention of pain, and U.S. claims data.
According to the researchers, the global age-standardized incidence rate of hip OA increased from 17.02 per 100,000 persons in 1990 to 18.7 per 100,000 persons in 2019, with an upward EAPC trend of 0.32 (0.29-0.34). Meanwhile, the age-standardized DALY rate increased from 11.54 per 100,000 persons to 12.57 per 100,000 persons, with an EAPC of 0.29 (0.27-0.32).
In 2019, EAPCs of the age-standardized incidence rate and age-standardized DALY rate for hip OA were positively associated with the SDI. Additionally, in 1990 and 2019, hip OA incidence was unimodally distributed across different age groups, with a peak incidence in the 60- to 64-year-old group, whereas DALYs increased with age.
“Hip osteoarthritis is a major global public health burden,” Fu and colleagues wrote. “Although the [age-standardized incidence rate] and age-standardized DALY rate of hip osteoarthritis vary among countries, the burden of hip osteoarthritis has increased in almost all countries over the past 30years. This increasing trend is expected to continue, due to the rapid aging of the world’s population. To mitigate the burden of hip osteoarthritis, the governments and health policymakers of all countries must increase the awareness regarding risk factors, consequences of hip osteoarthritis.”