| 1. |
- Kamps, Anne, et al.
(författare)
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Comorbidity in incident osteoarthritis cases and matched controls using electronic health record data
- 2023
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Ingår i: Arthritis Research and Therapy. - 1478-6354. ; 25:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Comorbidities are common in patients with osteoarthritis (OA). This study aimed to determine the association of a wide range of previously diagnosed comorbidities in adults with newly diagnosed OA compared with matched controls without OA. Methods: A case–control study was conducted. The data were derived from an electronic health record database that contains the medical records of patients from general practices throughout the Netherlands. Incident OA cases were defined as patients with one or more diagnostic codes recorded in their medical records that correspond to knee, hip, or other/peripheral OA. Additionally, the first OA code had to be recorded between January 1, 2006, and December 31, 2019. The date of cases’ first OA diagnosis was defined as the index date. Cases were matched (by age, sex, and general practice) to up to 4 controls without a recorded OA diagnosis. Odds ratios were derived for each 58 comorbidities separately by dividing the comorbidity prevalence of cases by that of their matched controls at the index date. Results: 80,099 incident OA patients were identified of whom 79,937 (99.8%) were successfully matched with 318,206 controls. OA cases had higher odds for 42 of the 58 studied comorbidities compared with matched controls. Musculoskeletal diseases and obesity showed large associations with incident OA. Conclusions: Most of the comorbidities under study had higher odds in patients with incident OA at the index date. While previously known associations were confirmed in this study, some associations were not described earlier.
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| 2. |
- Pineda-Moncusí, Marta, et al.
(författare)
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Classification of patients with osteoarthritis through clusters of comorbidities using 633,330 individuals from Spain
- 2023
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Ingår i: Rheumatology (Oxford, England). - : Oxford University Press (OUP). - 1462-0332. ; 62:11, s. 3592-3600
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To explore clustering of comorbidities among patients with a new diagnosis of osteoarthritis (OA) and estimate the 10-year mortality risk for each identified cluster.METHODS: This is a population-based cohort study of individuals with first incident diagnosis of OA of the hip, knee, ankle/foot, wrist/hand, or 'unspecified' site between 2006 and 2020, using SIDIAP (a primary care database representative from Catalonia, Spain). At the time of OA diagnosis, conditions associated with OA in the literature that were found in ≥ 1% of the individuals (n = 35) were fitted into two cluster algorithms, K-means and latent class analysis (LCA). Models were assessed using a range of internal and external criteria evaluation procedures. Mortality risk of the obtained clusters was assessed by survival analysis using Cox proportional hazards.RESULTS: We identified 633 330 patients with a diagnosis of OA. Our proposed best solution used LCA to identify four clusters: 'Low-morbidity (relatively low number of comorbidities), 'Back/neck pain plus mental health', 'Metabolic syndrome' and 'Multimorbidity' (higher prevalence of all study comorbidities). Compared with the 'Low-morbidity, the 'Multimorbidity' cluster had the highest risk of 10-year mortality (adjusted HR: 2.19 [95%CI: 2.15-2.23]), followed by 'Metabolic syndrome' (adjusted HR: 1.24 [95%CI: 1.22-1.27]]) and 'Back/neck pain plus mental health' (adjusted HR: 1.12 [95%CI: 1.09-1.15]).CONCLUSION: Patients with a new diagnosis of OA can be clustered into groups based on their comorbidity profile, with significant differences in 10-year mortality risk. Further research is required to understand the interplay between OA and particular comorbidity groups, and the clinical significance of such results.
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| 3. |
- Swain, Subhashisa, et al.
(författare)
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Comorbidities in osteoarthritis (ComOA) : a combined cross-sectional, case-control and cohort study using large electronic health records in four European countries
- 2022
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 12:4
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Osteoarthritis (OA) is one of the leading chronic conditions in the older population. People with OA are more likely to have one or more other chronic conditions than those without. However, the temporal associations, clusters of the comorbidities, role of analgesics and the causality and variation between populations are yet to be investigated. This paper describes the protocol of a multinational study in four European countries (UK, Netherlands, Sweden and Spain) exploring comorbidities in people with OA. Methods and analysis This multinational study will investigate (1) the temporal associations of 61 identified comorbidities with OA, (2) the clusters and trajectories of comorbidities in people with OA, (3) the role of analgesics on incidence of comorbidities in people with OA, (4) the potential biomarkers and causality between OA and the comorbidities, and (5) variations between countries. A combined case-control and cohort study will be conducted to find the temporal association of OA with the comorbidities using the national or regional health databases. Latent class analysis will be performed to identify the clusters at baseline and joint latent class analysis will be used to examine trajectories during the follow-up. A cohort study will be undertaken to evaluate the role of non-steroidal anti-inflammatory drugs (NSAIDs), opioids and paracetamol on the incidence of comorbidities. Mendelian randomisation will be performed to investigate the potential biomarkers for causality between OA and the comorbidities using the UK Biobank and the Rotterdam Study databases. Finally, a meta-analyses will be used to examine the variations and pool the results from different countries. Ethics and dissemination Research ethics was obtained according to each database requirement. Results will be disseminated through the FOREUM website, scientific meetings, publications and in partnership with patient organisations.
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