Hand osteoarthritis less prevalent among black patients
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Black populations demonstrated lower odds for hand osteoarthritis, compared with nonblack groups, according to data published in Arthritis & Rheumatology.
“Previous studies showed that black subjects have increased prevalence and more severe radiographic and symptomatic knee and hip OA, and the hereditary, environmental, or biomechanical factors have been suggested as the possible explanations for this difference,” Farhad Pishgar, MD, MPH, postdoctoral fellow at the Johns Hopkins University School of Medicine, and colleagues wrote. “However, there is little evidence on the potential association between race and hand OA; no difference was found in the prevalence of the symptomatic hand OA between black and nonblack subjects in the cross-sectional surveys.”
They added, “Investigating the association between race and hand OA can lead to a better understanding of the pathogenesis of the disease and proper tailoring of preventive or therapeutic strategies according to race.”
To examine the links between race — specifically black compared with nonblack populations — and radiographic, symptomatic and clinical hand OA, Pishgar and colleagues conducted a propensity-score-matched post-hoc analysis of data from the Osteoarthritis Initiative (OAI). Using the OAI cohort — which includes close to 5,000 patients with, or at risk for, knee OA — the researchers were able to identify 4,699 individuals with available hand radiographs. Among these individuals, 849 were black and 3,850 were nonblack.
The researchers used a propensity score-matching method to select black and nonblack participants matched for known potential hand OA risk factors, such as age, sex, BMI, smoking status, cardiovascular disease, osteoporosis, excessive hand use and knee OA. A musculoskeletal radiologist analyzed postero-anterior radiographs of individuals’ dominant hands, and modified KL grades — on a scale of mKL 0-4 — as well as the presence of erosive OA in the hand joints were recorded. Regression models were used to analyze associations between race and hand OA severity as well as the presence of radiographic, symptomatic and clinical hand OA.
According to the researchers, black individuals demonstrated less severe hand OA ( = –1.93; 95% CI, –2.53 to –1.34), as well as lower odds for radiographic (OR = 0.79; 95% CI, 0.66-0.94), erosive (OR = 0.23; 95% CI, 0.11-0.47), symptomatic (OR = 0.63; 95% CI, 0.49-0.82) and clinical (OR = 0.49; 95% CI, 0.41-0.6) hand OA.
“PS-matched comparative analysis, with well-balanced demographic and clinical characteristics among subjects with different races, enabled credible comparison of hand OA phenotypes in terms of prevalence and severity between black and nonblack subjects,” Pishgar and colleagues wrote. “Findings of this work showed that contrary to the knee and hip OA, odds of radiographic, symptomatic, and clinical hand OA are lower among black subjects. Future mechanistic works are warranted to determine the mediating protective factors for hand OA among the black subjects.” – by Jason Laday
Disclosure: Pishgar reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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