Synovitis and radiographic progression in non-erosive and erosive hand osteoarthritis: is erosive hand osteoarthritis a separate inflammatory phenotype?

Haugen, Ida K.; Mathiessen, Alexander; Slatkowsky-Christensen, Barbara; Magnusson, Karin; Bøyesen, Pernille; Sesseng, S.; Heijde, Desirée van der; Kvien, Tore K; Hammer, Hilde Berner

doi:10.1016/j.joca.2015.11.014

Cited by 62 publications

(58 citation statements)

References 35 publications

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“…However, synovitis is a risk factor for radiographic progression 26,27,28 and may occur in early disease 42 . Further, persons with erosive hand OA demonstrate more joint inflammation than persons with nonerosive disease 43 . Hence, the results from the 2 studies may conform.…”

Section: Discussionmentioning

confidence: 96%

The Prevalence, Incidence, and Progression of Hand Osteoarthritis in Relation to Body Mass Index, Smoking, and Alcohol Consumption

Haugen

Magnusson²,

Turkiewicz³

et al. 2017

J Rheumatol

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Objective To estimate the extent that overweight/obesity, smoking, and alcohol are associated with prevalence and longitudinal changes of radiographic hand osteoarthritis (OA). Methods Participants from the Osteoarthritis Initiative (n = 1232) were included, of whom 994 had 4-year followup data. In analyses on incident hand OA, only persons without hand OA at baseline were included (n = 406). Our exposure variables were overweight/obesity [body mass index (BMI), waist circumference], smoking (current/former, smoking pack-yrs), and alcohol consumption (drinks/week). Using linear and logistic regression analyses, we analyzed possible associations between baseline exposure variables and radiographic hand OA severity, erosive hand OA, incidence of hand OA, and radiographic changes. Analyses were adjusted for age, sex, and education. Results Neither overweight nor obesity were associated with hand OA. Current smoking was associated with less hand OA in cross-sectional analyses, whereas longitudinal analyses suggested higher odds of incident hand OA in current smokers (OR 2.20, 95% CI 1.02–4.77). Moderate alcohol consumption was associated with higher Kellgren-Lawrence sum score at baseline (1–3 drinks: 1.55, 95% CI 0.43–2.67) and increasing sum score during 4-year followup (4–7 drinks: 0.33, 95% CI 0.01–0.64). Moderate alcohol consumption (1–7 drinks/week) was associated with 2-fold higher odds of erosive hand OA, which was statistically significant. Additional adjustment for BMI gave similar strengths of associations. Conclusion Overweight/obesity were not associated with hand OA. Contrasting results were observed for smoking and hand OA, suggesting lack of association. Moderate alcohol consumption was associated with hand OA severity, radiographic changes, and erosive hand OA, warranting further investigation.

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Section: Discussionmentioning

confidence: 96%

The Prevalence, Incidence, and Progression of Hand Osteoarthritis in Relation to Body Mass Index, Smoking, and Alcohol Consumption

Haugen

Magnusson²,

Turkiewicz³

et al. 2017

J Rheumatol

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show abstract

“…In contrast, none of the 34 patients with erosive hand OA in the Oslo hand OA cohort had self-reported diabetes, whereas 6/31 (19%) of the patients with non-erosive disease reported to have diabetes [23]. Both studies are hampered by small study samples.…”

Section: Discussionmentioning

confidence: 99%

Long term type 1 diabetes is associated with hand pain, disability and stiffness but not with structural hand osteoarthritis features – The Dialong hand study

et al. 2017

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ObjectiveTo explore whether having long-term type 1 diabetes (>45 years) is associated with a higher prevalence of radiographic hand OA, erosive hand OA and increased hand pain, disability and stiffness.MethodsIn total N = 96 persons with type 1 diabetes diagnosed before 1970 were included (mean [SD] age: 62.2 [7.4], mean [SD] HbA1c: 7.43 [0.80] and N = 49 [51%] men). Regular measurements of their HbA1c were obtained till 2015. We included N = 69 healthy controls without any diabetes (mean [SD] age: 63.0 [7.0], mean [SD] HbA1c: 5.41 [0.32], N = 29 [42%] men). The groups were compared for radiographic hand OA (Kellgren-Lawrence grade ≥2 in ≥1 joint) and erosive hand OA (central erosions in ≥1 joint), Australian/Canadian index (AUSCAN) for hand pain, disability and stiffness using regression analyses adjusted for age, sex, educational level and waist circumference.ResultsWe found no associations between having long term type 1 diabetes and more prevalent radiographic hand OA (OR = 0.83, 95% CI = 0.38–1.81). We found a trend towards higher prevalence of erosive hand OA in diabetes patients (OR = 2.96, 95% CI = 0.82–10.64). Strong and consistent associations were observed between long term type 1 diabetes and increased hand pain (B = 2.78, 95% CI = 1.65–3.91), disability (B = 5.30, 95% CI = 3.48–7.12) and stiffness (B = 2.00, 95% CI = 1.33–2.67). These associations were particularly strong for women and participants below the median age of 61 years.ConclusionLong-term type 1 diabetes was not associated with radiographic hand OA, but was strongly associated with hand pain, disability and stiffness. The association between diabetes and erosive hand OA warrants further investigation.

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“…Erosive hand OA has a higher clinical burden than non-erosive forms of hand OA and the associated disability might be as severe as that associated with rheumatoid arthritis (RA), depending on the setting 49,50 .…”

Section: [H1] Disease Presentation and Burdenmentioning

confidence: 99%

Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management

et al. 2018

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Osteoarthritis (OA) is a highly prevalent condition and the hand is the most commonly affected site. Patients with hand OA frequently report symptoms of pain, functional limitations, and frustration in undertaking everyday activities. The condition presents clinically with changes to the bone, ligaments, cartilage and synovial tissue, which can be observed using radiography, ultrasonography or MRI. Hand OA is a heterogeneous disorder and is considered to be multifactorial in aetiology. This review provides an overview of the epidemiology, presentation and burden of hand OA, including an update on hand OA imaging (including the development of novel techniques), disease mechanisms and management. In particular, areas for which new evidence has substantially changed the way we understand, consider and treat hand OA are highlighted. For example, genetic studies, clinical trials and careful prospective imaging studies from the past 5 years are beginning to provide insights into the pathogenesis of hand OA that might uncover new therapeutic targets in disease.

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Synovitis and radiographic progression in non-erosive and erosive hand osteoarthritis: is erosive hand osteoarthritis a separate inflammatory phenotype?

Abstract: Erosive HOA is characterized by higher frequency and more severe synovitis, pain and radiographic progression compared to non-erosive HOA. The higher rate of disease progression was independent of baseline synovitis and structural damage.

Cited by 62 publications

References 35 publications

The Prevalence, Incidence, and Progression of Hand Osteoarthritis in Relation to Body Mass Index, Smoking, and Alcohol Consumption

The Prevalence, Incidence, and Progression of Hand Osteoarthritis in Relation to Body Mass Index, Smoking, and Alcohol Consumption

Long term type 1 diabetes is associated with hand pain, disability and stiffness but not with structural hand osteoarthritis features – The Dialong hand study

Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management

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