Osteoarthritis (OA) is a common chronic condition in older people but its association; with other chronic conditions is largely unknown. The study aim to systematically review the literature on comorbidities; in people with OA compared to those without. Individuals with osteoarthritis have a 2.5-times greater risk for having three or more other chronic conditions; including stroke and peptic ulcers, compared with those without osteoarthritis; according to findings published in Arthritis Care & Research.

“A systematic review on OA reported worsening of pain and decline in functional activities; among people due to the presence of other chronic conditions,” Subhashisa Swain, MPH, of the University of Nottingham in the UK; and colleagues wrote. “Clinically, comorbidities in OA create greater challenges for management.

Patients with osteoarthritis

The number and pattern of different co morbid conditions determine the severity; and burden in multi morbid patients. However, except for shared risk factors such as aging and obesity; little is known about biological plausibility to explain concurrence of OA and associated comorbidities.”

To review the current literature regarding comorbidities among patients with OA; compared with those without the disease, Swain and colleagues searched Medline, PubMed, Embase and Scopus databases for studies publish between Jan. 1, 1995, and Dec. 31, 2017. The researchers also searched “comorbidity in OA” in Google Scholar. Specifically, the researchers limited their search to studies of OA only; as well as those that compared patients with OA with control participants.

The initial literature review yielded 70,014 articles, of which 1,091 remain; after discarding duplicates and irrelevant studies. Further review confirmed 56 relevant articles, of which 42 studies, from 16 countries; met the eligibility criteria. Swain and colleagues determined risk for bias and study quality using the Newcastle Ottawa Scale.

Pool prevalence of any comorbidity

According to the researchers, the pool prevalence of any comorbidity; was 67% among patients with OA (95% CI, 57%74%), compared with 56% in those without OA (95% CI, 44%-68%). Meanwhile, the pooled prevalence ratio for any comorbidity was 1.21 (95% CI, 1.021.45). The prevalence ratio (PR) increased from 0.73 for one comorbidity; to 1.58 for two , as well as to 1.94 for three or more. Comorbidities most associated with OA were stroke, peptic ulcer and metabolic syndrome.

“People with OA are 1.2 times more likely to have any comorbidity than non-OA controls; and 2.5 times more likely to have three or more comorbidities,” Swain and colleagues wrote. “The comorbidities with the highest increase in risk are stroke; peptic ulcer, hypertension and depression. Further research is needed to determine the causality between OA and these common comorbidities to optimize treatment and develop preventative strategies.” said Jason Laday