Patients using antihistamines show decreased structural progression in knee osteoarthritis
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Patients with knee osteoarthritis receiving antihistamines demonstrate less structural disease progression, compared with those who did not take antihistamines, over 2 years, according to data presented at the EULAR 2022 Congress.
“As one of the primary effects of antihistamines is indeed inhibition of mast cell degranulation, we hypothesized that for people with osteoarthritis, the use of antihistamines is associated with a reduced risk of structural progression,” Asger Reinstrup Bihlet, MSc, of NBCD A/S, a biotechnology firm specializing in knee OA, based in Herlev, Denmark, told attendees.
To investigate the impact of antihistamines on OA structural progression, Bihlet and colleagues conducted a post hoc analysis of two phase 3 trials analyzing the use of oral salmon calcitonin in knee OA. The trials investigated the impacts over a 2-year period. The primary outcome measure in both studies was structural progression, as defined as “the change in minimum joint-space width measured by use of X-ray imaging from baseline to year 2,” Bihlet said. The researchers reported antihistamine use as any medication coded R06A.
Bihlet and colleagues evaluated outcomes in patients who used antihistamines compared with patients who did not. In addition, patients were placed into groups based on periods of antihistamine use, defined as 1 to 49 days, 50 to 299 days and more than 300 days. The analysis was conducted using the ANCOVA system, with adjustments made for age, sex, BMI and baseline joint-space width.
The analysis included a total of 2,206 patients. Of those, 1,485 patients completed the trial. There were 1,327 patients who reported no antihistamine use during the duration of the study, and 158 who reported any duration of use. In all, there were 74 patients in the 1-to-49-day group, 21 patients in the 50-to-299-day group and 63 in the more-than-300-day group. According to the researchers, the mean change in joint-space width among non-users of antihistamine was –0.32 mm (95% CI, –0.36 to –0.29), compared with –0.19 mm (95% CI, –0.29 to –0.08) in patients who reported antihistamine use of any duration.
“In a post hoc analysis of these two clinical trials in OA, the participants taking antihistamines underwent less structural progression compared to those who did not take antihistamines during the 2-year study period,” Bihlet said. “The observed reduction in structural progression appeared to be associated with the duration of antihistamine treatment.”
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Bihlet AR, et al. Antihistamine use and structural progression of knee OA: A Post-Hoc analysis of two phase III clinical trials. Presented at: EULAR 2022 Congress; June 1-4, 2022 (virtual meeting).
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