Painful knee but not hand osteoarthritis is an independent predictor of mortality over 23 years follow-up of a population-based cohort of middle-aged women

Kluzek, Stefan; Sanchez‐Santos, Maria T; Leyland, K M; Judge, Andrew; Spector, Tim D.; Hart, David J.; Cooper, Cyrus; Newton, Julia L.; Arden, N K

doi:10.1136/annrheumdis-2015-208056

Cited by 93 publications

(95 citation statements)

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“…After excluding 2,124 articles based on title/abstract review, 15 articles were fully retrieved and six were included [37][38][39][40][41][42] along with data from the PRO.V.A study (Supplementary Figure 1). For one conference abstract 38 , additional data were gathered from the Authors.…”

Section: Search Resultsmentioning

confidence: 99%

“…In four studies (PRO.V.A) and 37,38,41 , OA was significantly associated with CVD death without heterogeneity or publication bias (HR=1.21; 95% CI: 1.10 to 1.34; p<0.001; I 2 =0%). Cause-specific mortality for single joints could not be computed due to the limited number of studies.…”

Section: Hazard Ratios For Cause-specific (Cvd) Mortalitymentioning

confidence: 99%

“…Since the pooled HR for hand OA on overall mortality appeared to be marginally protective (p=0.07), a sensitivity analysis was conducted to remove the effect of three datasets (PRO.V.A 40,41 ). This analysis demonstrated that for hand OA, pooled HR for mortality was 1.18 (95% CI: 1.07 to 1.30; p=0.001; I 2 =48%)…”

Section: Meta-regression Analysismentioning

confidence: 99%

“…In a great part of the strata heterogeneity remained high. However, in some studies there was a significantly higher risk of overall mortality and a moderate-to-substantial reduction of between-18 study heterogeneity: European studies; death ascertainment using death certificates; multiple joints affected; radiological diagnosis of OA.Since the pooled HR for hand OA on overall mortality appeared to be marginally protective (p=0.07), a sensitivity analysis was conducted to remove the effect of three datasets (PRO.V.A 40,41 ). This analysis demonstrated that for hand OA, pooled HR for mortality was 1.18 (95% CI: 1.07 to 1.30; p=0.001; I 2 =48%)…”

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confidence: 99%

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Osteoarthritis and mortality: A prospective cohort study and systematic review with meta-analysis

Veronese

Cereda

Maggi

et al. 2016

Seminars in Arthritis and Rheumatism

147

102

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Objectives: Osteoarthritis (OA) is a leading cause of disability, but the relationship with premature mortality remains uncertain. We aimed to investigate the relationship between OA and mortality from any cause and from cardiovascular disease (CVD).Methods: Electronic literature databases searches were conducted to identify prospective studies comparing mortality in a sample of people with and without OA.Risk of call-cause and CVD-mortality were summarized using adjusted hazard ratios (HRs) for joint-specific (hand, hip and knee) and joint non-specific OA. New data from the Progetto Veneto Anziani (PRO.V.A.) study were also included.Results: From the PRO.V.A. study (N=2,927), there was no significant increase in CVD mortality risk for participants with any-joint OA (N=1,858) compared to non-OA (all-cause, HR=0.95; 95% CI: 0.77-1.15; CVD, HR=1.12; 95% CI: 0.82-1.54).On meta-analysis, seven studies (OA: 10,018/non-OA: 18,541), with a median 12-year follow-up, reported no increased risk of any-cause mortality in those with OA (HR=1.10; 95% CI: 0.97-1.25). After removing data on hand OA, a significant association between OA and mortality was observed (HR=1.18; 95% CI: 1.08-1.28).There was a significant higher risk of overall mortality for (1) studies conducted in Europe, (2) patients with multi-joint OA; and (3) a radiological diagnosis of OA. OA was associated with significantly higher CVD mortality (HR=1.21; 95% CI: 1.10-1.34). CVD is potentially preventable through appropriate timely pharmacological and non-pharmacological interventions 10 Therefore, to identify people at higher risk of CVD mortality could be of considerable public health importance.Within the past decade, a number of observational studies have reported that people with OA are at increased risk of premature mortality compared to the general population. [11][12][13] However, this evidence is heterogeneous and limited by the lack of adjustment for appropriate confounders.Given this, the purpose of this study was to: i) analyze data from a prospective cohort study on the risk of CVD mortality in OA compared to a non-osteoarthritis cohort, adjusting for important medical morbidities and other confounders; ii) to systematically review the available literature and perform a meta-analysis to 7 determine whether people with OA present a differential risk of overall and CVD mortality than those without OA. We hypothesized that people with OA had a significant higher risk of overall and CVD death compared to those without OA. 8 MATERIALS AND METHODS Prospective cohort study Overall cohortPreviously unpublished data from the Progetto Veneto Anziani (PRO.V.A. study)were used to investigate the risk of overall and CVD mortality in people with OA over a mean follow-up of 4.4 years. The Pro.V.A. study is an observational cohort study on the Italian population aged over 65 years. The study population initially included 3,099 older Caucasian adults (1,245 men/1,854 women), who were randomly selected between 1995 and 1997 using a multistage stratified met...

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Section: Search Resultsmentioning

confidence: 99%

Section: Hazard Ratios For Cause-specific (Cvd) Mortalitymentioning

confidence: 99%

Section: Meta-regression Analysismentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Osteoarthritis and mortality: A prospective cohort study and systematic review with meta-analysis

Veronese

Cereda

Maggi

et al. 2016

Seminars in Arthritis and Rheumatism

147

102

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“…5 The Chingford Cohort Study evaluated a community-based population of women aged 45-64 years who resided in Northern London. 6 This population included 821 women with knee OA and found that women with symptomatic knee OA had an increased all-cause mortality (HR 1.97[95% CI 1.23-3.17]), and an increased cardiovascular mortality (HR 3.57[95% CI 1.53-8.34]).…”

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confidence: 99%

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2018

IPMRJ

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Associations Between Clinical Evidence of Inflammation and Synovitis in Symptomatic Knee Osteoarthritis: A Cross‐Sectional Substudy

Wallace

Cro

Doré

et al. 2017

Arthritis Care & Research

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Objective Painful knee osteoarthritis (KOA) has been associated with joint inflammation. There is, however, little literature correlating signs of localized inflammation with contrast‐enhanced (CE) magnetic resonance imaging (MRI) of synovium. This study examined the relationship between clinical and functional markers of localized knee inflammation and CE MRI–based synovial scores. Methods Patients with symptomatic KOA were enrolled into the randomized, double‐blind, Vitamin D Evaluation in Osteoarthritis (VIDEO) trial. In this cross‐sectional substudy, associations between validated MRI‐based semiquantitative synovial scores of the knee and the following markers of inflammation were investigated: self‐reported pain and stiffness, effusion, warmth, joint line tenderness, erythrocyte sedimentation rate, radiographic severity, and functional ability tests. Results A total of 107 patients satisfied the inclusion criteria of complete data and were included in the analysis. Significant associations were found between the number of regions affected by synovitis and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, effusion, and joint line tenderness. Each additional region affected by synovitis was associated with an increase in WOMAC pain (1.82 [95% confidence interval (95% CI) 0.05, 3.58], P = 0.04), and the association with extent of medial synovitis was particularly strong (3.21 [95% CI 0.43, 5.99], P = 0.02). Extent of synovitis was positively associated with effusion (odds ratio 1.69 [95% CI 1.37, 2.08], P < 0.01) and negatively associated with joint line tenderness (relative risk 0.87 [95% CI 0.84, 0.90], P < 0.01). Conclusion There is a strong positive association between synovitis and self‐reported patient pain and clinically detectable effusion. Nonoperative treatments directed at management of inflammation and future trials targeting the synovial tissue for treating KOA should consider these 2 factors as potential inclusion criteria.

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Painful knee but not hand osteoarthritis is an independent predictor of mortality over 23 years follow-up of a population-based cohort of middle-aged women

Cited by 93 publications

References 48 publications

Osteoarthritis and mortality: A prospective cohort study and systematic review with meta-analysis

Osteoarthritis and mortality: A prospective cohort study and systematic review with meta-analysis

Untitled

Associations Between Clinical Evidence of Inflammation and Synovitis in Symptomatic Knee Osteoarthritis: A Cross‐Sectional Substudy

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