In the 2023 update of their recommendations for osteoarthritis management, EULAR – The European Alliance of Associations for Rheumatology – recognise osteoarthritis as a severe disease, and one with important implications for both the individual and society.3 However, most people with osteoarthritis do not receive optimal management,4,5 and this represents an important unmet need – especially when considering additional systemic comorbidities. To explore this further, ComOA6 has combined case-control and cohort studies for over 3 million people in primary care in the UK, Netherlands, Sweden, and Spain. The analyses – shared at the 2024 EULAR congress in Vienna – examines associations between osteoarthritis and 61 different comorbidities identified before and after the first osteoarthritis diagnosis. The researches then tested the similarity of their findings across the four countries – where congruency was determined to be present if the results of all centres were significant and favoured in one direction.
Across the four databases there were 845,373 osteoarthritis cases and 2,556,243 controls. Pooled prevalence data showed several conditions that were more common in people with osteoarthritis than in matched controls. The conditions with leading prevalence were chronic back pain, hypertension, allergy, cataract, vertigo, depression, and diabetes. Of 33 comorbidities studied, 10 such as fibromyalgia, polymyalgia, and chronic back pain showed congruent evidence of association with osteoarthritis during the diagnosis across the four countries. The three major comorbidities developed after the diagnosis of osteoarthritis were fibromyalgia, rheumatoid arthritis, and polymyalgia. No congruent evidence of association with either before or after the diagnosis of osteoarthritis was found for 14 chronic conditions, including heart failure, diabetes, dementia, and chronic obstructive pulmonary disease.
These are important findings to consider for planning management of people with osteoarthritis, and suggest further research is warranted to establish the causal association between osteoarthritis and its comorbidities.
Source
Swain S, et al. Comorbidities in people with osteoarthritis in four European primary care settings - comprehensive evidence from the ComOA study. Presented at EULAR 2024; OP0230.
Ann Rheum Dis 2024; DOI: 10.1136/annrheumdis-2024-eular.3327.
References
1. EULAR RheumaMap. A research roadmap to transform the lives of people with rheumatic and musculoskeletal diseases; 2019.
2. Hunter DJ, Bierma- Zeinstra S. Osteoarthritis. Lancet 2019;393:1745–59.
3. Moseng T, et al. EULAR recommendations for the non- pharmacological core management of hip and knee osteoarthritis: 2023 update. Ann Rheum Dis 2024; doi:10.1136/ard-2023-225041.
4. Basedow M, Esterman A. Assessing appropriateness of osteoarthritis care using quality indicators: a systematic review. J Eval Clin Pract 2015;21:782–9.
5. Hagen KB, et al. Quality of community- based osteoarthritis care: a systematic review and meta- analysis. Arthritis Care Res (Hoboken) 2016;68:1443–52.
6. Swain S, et al. Comorbidities in osteoarthritis (ComOA): a combined cross-sectional, case–control and cohort study using large electronic health records in four European countries. BMJ Open 2022;12:e052816.
About EULAR
EULAR is the European umbrella organisation representing scientific societies, health professional associations and organisations for people with rheumatic and musculoskeletal diseases (RMDs). EULAR aims to reduce the impact of RMDs on individuals and society, as well as improve RMD treatments, prevention, and rehabilitation. To this end, EULAR fosters excellence in rheumatology education and research, promotes the translation of research advances into daily care, and advocates for the recognition of the needs of those living with RMDs by EU institutions.
