OP0230 COMORBIDITIES IN PEOPLE WITH OSTEOARTHRITIS IN FOUR EUROPEAN PRIMARY CARE SETTINGS - COMPREHENSIVE EVIDENCE FROM THE ComOA STUDY

Swain, S.; Coupland, C.; Kamps, A.; Runhaar, J.; Dell’isola, A.; Mallen, C.; Kuo, C.F.; Doherty, M.; Prieto-Alhambra, D.; Englund, M.; Bierma-Zeinstra, S.M.A.; Zhang, W.

Abstract

Background:
Associations of osteoarthritis (OA) with different comorbidities have gained attention recently. However, there is no literature on the congruency across different large primary care settings.

Objectives:
We examined the associations of OA with 61 different comorbidities diagnosed before and after the first diagnosis of OA in four different European primary care settings from the United Kingdom, the Netherlands, Sweden, and Spain. We tested the congruency and incongruency of the findings across these four countries. Congruency was present if the results of all the centres were significant and favoured in one direction.

Methods:
The multicentre ComOA study(1) combined case-control and cohort studies for a total of 3,401,616 people aged 18 or above from four countries’ large primary care records in the UK (CPRD GOLD, n= 518,000), Netherlands (IPCI, n=398,143), Sweden (Skane, n=548,681), and Spain (SIDIAP, n=1,936,792). The study population consisted of incident OA cases and age, sex, and practice matched controls without OA. We examined bidirectional association of 61 comorbidities with OA using case-control and cohort methodology, reported as odds ratios (OR) and hazard ratios (HR) and adjusting for other covariates. Pooled proportions with comorbidities, ORs and HRs were estimated using random effect methods.

Results:
Four databases had 845,373 OA cases and 2,556,243 controls. Of 61 comorbidities, all centres examined 33 and 8 conditions in both retrospective and prospective analyses, respectively. The percentage of women participants varied from 41.6% in SIDIAP to 64.0% in IPCI. Mean age at the diagnosis of OA was lowest in CPRD GOLD (59.8 years, SD12.8), and highest in IPCI (65.8 years, SD 12.19). In people with OA the pooled prevalence (%) of the top conditions which were higher than matched controls were: chronic back pain (43.8; 95% CI: 33.0-54.8), hypertension (34.3; 95% CI 26.4-42.6), allergy (21.2; 95% CI 10.3-34.6), cataract (16.0; 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). Of 33 comorbidities studied retrospectively, 10 showed congruent evidence of association with OA across the four countries. The three leading comorbidities before the diagnosis of OA were fibromyalgia (OR 1.93; 95% CI 1.49-2.49), polymyalgia (1.44; 95% CI 1.31-1.58), and chronic back pain (1.42; 95% CI 1.32-1.53). (Figure 1) 32 of 61 comorbidities showed congruent evidence of association prospectively by at least three centres. (Figure 2) The three leading comorbidities developed after the diagnosis of OA were fibromyalgia (HR: 1.42; 95% CI 1.29-1.56), rheumatoid arthritis (HR: 1.27; 95% CI 1.20-1.35), and polymyalgia (HR: 1.24; 95% CI 1.20-1.27). Non-congruent evidence was found for 14 chronic conditions, either retrospectively or prospectively, such as heart failure, diabetes, dementia, and chronic obstructive pulmonary disease (COPD).

Conclusion:
OA is associated with a large number of chronic conditions, especially for painful musculoskeletal conditions, across different countries in Europe, despite different population structures and health systems. Further research is needed to establish the causal association.

Citation

Swain, S., Coupland, C., Kamps, A., Runhaar, J., Dell’isola, A., Mallen, C., Kuo, C., Doherty, M., Prieto-Alhambra, D., Englund, M., Bierma-Zeinstra, S., & Zhang, W. OP0230 COMORBIDITIES IN PEOPLE WITH OSTEOARTHRITIS IN FOUR EUROPEAN PRIMARY CARE SETTINGS - COMPREHENSIVE EVIDENCE FROM THE ComOA STUDY. Presented at EULAR 2024, Vienna, Austria

• Presentation Conference Type: Conference Abstract
• Conference Name: EULAR 2024
• Acceptance Date: Jun 1, 2024
• Online Publication Date: Jan 2, 2025
• Deposit Date: Jan 16, 2025
• Journal: Annals of the Rheumatic Diseases
• Print ISSN: 0003-4967
• Electronic ISSN: 1468-2060
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 83
• Pages: 119-120
• DOI: https://doi.org/10.1136/annrheumdis-2024-eular.3327
• Public URL: https://keele-repository.worktribe.com/output/1046930
• Publisher URL: https://www.sciencedirect.com/science/article/abs/pii/S0003496724151527