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Temporal relationship between osteoarthritis and comorbidities : A combined case control and cohort study in the UK primary care setting

Swain, Subhashisa ; Coupland, Carol ; Mallen, Christian ; Kuo, Chang Fu ; Sarmanova, Aliya ; Bierma-Zeinstra, Sita M.A. ; Englund, Martin LU orcid ; Prieto-Alhambra, Daniel ; Doherty, Michael and Zhang, Weiya (2021) In Rheumatology 60(9). p.4327-4339
Abstract

Objective: To determine the burden of comorbidities in OA and their temporal relationships in the UK. Methods: The Clinical Practice Research Datalink (CPRD) GOLD was used to identify people with incident OA and age, gender and practice matched non-OA controls from UK primary care. Controls were assigned the same index date as matched cases (date of OA diagnosis). Associations between OA and 49 individual comorbidities and multimorbidities (two or more comorbidities excluding OA) both before and after OA diagnosis were estimated, adjusting for covariates, using odds ratios (aORs) and hazard ratios (aHRs), respectively. Results: During 1997-2017, we identified 221 807 incident OA cases and 221 807 matched controls. Of 49 comorbidities... (More)

Objective: To determine the burden of comorbidities in OA and their temporal relationships in the UK. Methods: The Clinical Practice Research Datalink (CPRD) GOLD was used to identify people with incident OA and age, gender and practice matched non-OA controls from UK primary care. Controls were assigned the same index date as matched cases (date of OA diagnosis). Associations between OA and 49 individual comorbidities and multimorbidities (two or more comorbidities excluding OA) both before and after OA diagnosis were estimated, adjusting for covariates, using odds ratios (aORs) and hazard ratios (aHRs), respectively. Results: During 1997-2017, we identified 221 807 incident OA cases and 221 807 matched controls. Of 49 comorbidities examined, 38 were associated with OA both prior to and following the diagnosis of OA and 2 (dementia and systemic lupus erythematosus) were associated with OA only following the diagnosis of OA. People with OA had a higher risk of developing heart failure [aHR 1.63 (95% CI 1.56, 1.71)], dementia [aHR 1.62 (95% CI 1.56, 1.68)], liver diseases [aHR 1.51 (95% CI 1.37, 1.67)], irritable bowel syndrome [aHR 1.51 (95% CI 1.45, 1.58)], gastrointestinal bleeding [aHR 1.49 (95% CI 1.39, 1.59)], 10 musculoskeletal conditions and 25 other conditions following OA diagnosis. The aOR for multimorbidity prior to the index date was 1.71 (95% CI 1.69, 1.74), whereas the aHR for multimorbidity after the index date was 1.29 (95% CI 1.28, 1.30). Conclusions: People with OA are more likely to have other chronic conditions both before and after the OA diagnosis. Further study on shared aetiology and causality of these associations is needed.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
burden, comorbidity, multimorbidity, osteoarthritis, temporal association
in
Rheumatology
volume
60
issue
9
pages
13 pages
publisher
Oxford University Press
external identifiers
  • pmid:33506862
  • scopus:85115249045
ISSN
1462-0332
DOI
10.1093/rheumatology/keab067
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2021 The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology.
id
7af1be97-6aad-436b-a210-19634c1ac436
date added to LUP
2022-02-23 09:12:33
date last changed
2024-04-18 06:00:25
@article{7af1be97-6aad-436b-a210-19634c1ac436,
  abstract     = {{<p>Objective: To determine the burden of comorbidities in OA and their temporal relationships in the UK. Methods: The Clinical Practice Research Datalink (CPRD) GOLD was used to identify people with incident OA and age, gender and practice matched non-OA controls from UK primary care. Controls were assigned the same index date as matched cases (date of OA diagnosis). Associations between OA and 49 individual comorbidities and multimorbidities (two or more comorbidities excluding OA) both before and after OA diagnosis were estimated, adjusting for covariates, using odds ratios (aORs) and hazard ratios (aHRs), respectively. Results: During 1997-2017, we identified 221 807 incident OA cases and 221 807 matched controls. Of 49 comorbidities examined, 38 were associated with OA both prior to and following the diagnosis of OA and 2 (dementia and systemic lupus erythematosus) were associated with OA only following the diagnosis of OA. People with OA had a higher risk of developing heart failure [aHR 1.63 (95% CI 1.56, 1.71)], dementia [aHR 1.62 (95% CI 1.56, 1.68)], liver diseases [aHR 1.51 (95% CI 1.37, 1.67)], irritable bowel syndrome [aHR 1.51 (95% CI 1.45, 1.58)], gastrointestinal bleeding [aHR 1.49 (95% CI 1.39, 1.59)], 10 musculoskeletal conditions and 25 other conditions following OA diagnosis. The aOR for multimorbidity prior to the index date was 1.71 (95% CI 1.69, 1.74), whereas the aHR for multimorbidity after the index date was 1.29 (95% CI 1.28, 1.30). Conclusions: People with OA are more likely to have other chronic conditions both before and after the OA diagnosis. Further study on shared aetiology and causality of these associations is needed.</p>}},
  author       = {{Swain, Subhashisa and Coupland, Carol and Mallen, Christian and Kuo, Chang Fu and Sarmanova, Aliya and Bierma-Zeinstra, Sita M.A. and Englund, Martin and Prieto-Alhambra, Daniel and Doherty, Michael and Zhang, Weiya}},
  issn         = {{1462-0332}},
  keywords     = {{burden; comorbidity; multimorbidity; osteoarthritis; temporal association}},
  language     = {{eng}},
  month        = {{09}},
  number       = {{9}},
  pages        = {{4327--4339}},
  publisher    = {{Oxford University Press}},
  series       = {{Rheumatology}},
  title        = {{Temporal relationship between osteoarthritis and comorbidities : A combined case control and cohort study in the UK primary care setting}},
  url          = {{http://dx.doi.org/10.1093/rheumatology/keab067}},
  doi          = {{10.1093/rheumatology/keab067}},
  volume       = {{60}},
  year         = {{2021}},
}