Patients with atopic disease demonstrate increased osteoarthritis incidence
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Key takeaways:
- Patients with atopic dermatitis and asthma are more likely to develop osteoarthritis.
- The researchers said future studies may consider targeting allergic pathways in the treatment of OA.
Patients with atopic diseases may be at an increased risk for developing osteoarthritis, according to data published in Annals of the Rheumatic Diseases.
“We have previously published a study showing that patients with osteoarthritis have increased numbers and activity of mast cells in the joints, which contribute to osteoarthritis pathogenesis,” Matthew C. Baker, MD, of the department of immunology and rheumatology at Stanford University, told Healio. “Mast cells are generally involved in allergic responses, but their mediators (tryptase, histamine) can cause inflammation and damage as well.
“Given this preclinical observation, we hypothesized that patients with allergic diseases such as asthma and atopic dermatitis (eczema) might have an increased risk of developing osteoarthritis,” he added.
To investigate the connection between atopic disease and OA risk, Baker and colleagues conducted a retrospective cohort study of information from the Optum CDM cohort, as well as a separate cohort to replicate the data. The researchers included adult patients aged 18 years or older with at least 7 years of continuous enrollment in the Optum CDM cohort. Patients were excluded if they received a diagnosis of OA or atopic disease within the first 2 years of their enrollment. The researchers placed patients in the exposed group if they had received a diagnosis of atopic disease, specifically atopic dermatitis or asthma.
The primary outcome was the development of OA. For the purposes of the analysis, OA was defined based on two separate diagnostic codes for the disease 7 or more days apart. Secondary endpoints included specific instances of OA, including knee and hip.
The analysis included 117,346 exposed patients and 1,247,196 non-exposed patients from the Optum CDM cohort. According to the researchers, OA was more common among the exposed group, at 26.9 per 1000 person-years, compared with 19.1 per 1000 person-years among the non-exposed group (OR = 1.58; 95% CI, 1.73-1.95). Patients with both asthma and atopic dermatitis were also more likely to develop OA than non-exposed patients (OR = 2.15; 95% CI, 1.93-2.39). The researchers replicated the results using the STARR cohort (OR = 1.42; 95% CI, 1.36-1.48).
“We found an association between having allergic diseases such as asthma and atopic dermatitis and having an increased risk of developing osteoarthritis,” Baker said. “Before this study, our group has done work showing that mast cells — a type of allergic cell — are increased in numbers in the joints of people with osteoarthritis, and their activity contributes to the development of osteoarthritis. We are hopeful that in the future this observation will lead to interventional studies investigating whether inhibition of allergic pathways may be beneficial in preventing or treating osteoarthritis.”
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