RA, fibromyalgia impact patients with osteoarthritis ‘quite substantially over time’
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Rheumatoid arthritis and fibromyalgia are among the most common comorbidities identified in patients following a diagnosis of osteoarthritis, according to data presented at the EULAR 2024 Congress.
“I decided to go for this osteoarthritis abstract because it is a very important one that looks at a large-scale European endeavor,” EULAR President Daniel Aletaha, MD, of the division of rheumatology at the Medical University of Vienna, in Austria, told attendees at a press conference during the meeting. “It is a study that covers three million people in a case-control approach to understand how these people are affected by comorbidities.
“Patients with OA don’t have good drugs and they don’t have good care,” he added. “That means that they do not take care of their comorbidities.”
For the current analysis, Weiya Zhang, PhD, MSc, of the University of Nottingham, in the United Kingdom, and colleagues assessed associations between OA and 61 different comorbidities identified before and after the first diagnosis of OA. The analysis included more than 3.4 million patients across four countries — the Netherlands, the United Kingdom, Spain and Sweden. Data from four databases yielded 845,373 OA cases and 2,556,243 controls.
Among the 61 comorbidities that were included, 33 conditions were studied in retrospective analyses and eight were studied in prospective analyses.
According to the pooled prevalence data, conditions that were more common in patients with OA, compared with matched controls, were chronic back pain (43.8%; 95% CI, 33-54.8), hypertension (34.3%; 95% CI, 26.4-42.6), allergy (21.2%; 95% CI, 10.3-34.6), cataract (16%; 95% CI, 9.6-23.6), vertigo (13.8%; 95% CI, 13.7-13.9), depression (12.8%; 95% CI, 8.2-18.6) and diabetes (12.8%; 95% CI, 9.3-16.8).
Looking closer at the 33 comorbidities studied retrospectively, results showed that 10 demonstrated congruent evidence of association with OA across the four countries studied.
According to the researchers, the comorbidity that was most diagnosed before OA was fibromyalgia (OR = 1.93; 95% CI, 1.49-2.49). Other commonly diagnosed comorbidities diagnosed before OA were polymyalgia (OR = 1.44; 95% CI, 1.31-1.58) and chronic back pain (OR = 1.42; 95% CI, 1.32-1.53).
The most diagnosed comorbidity after OA diagnosis was fibromyalgia (HR = 1.42; 95% CI, 1.29-1.56) followed by RA (HR = 1.27; 95% CI, 1.2-1.35) and polymyalgia (HR = 1.24; 95% CI, 1.2-1.27).
“This survey shows that a lot of these patients have other musculoskeletal diseases like rheumatoid arthritis, fibromyalgia or polymyalgia,” Aletaha said. “Maybe not at baseline, but they develop it over time.”
Congruent evidence of association with OA was prospectively observed in 32 of 61 comorbidities in at least three of the study sites, the researchers wrote. Non-congruent evidence of association with OA was reported for 14 conditions either retrospectively or prospectively, according to the findings. Some of these comorbidities included heart failure, diabetes, dementia, and chronic obstructive pulmonary disease.
“This large-scale study shows that this disease — potentially misperceived as not so dramatic — is actually affecting people quite substantially, not only by prevalence but also by the comorbidities that they carry over time,” Aletaha said.
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Swain S. OP0230. Presented at: EULAR 2024 Congress; June 12 to June 15, 2024, Vienna, Austria.
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