Comorbid CVD, diabetes reduce likelihood of improvement in hand osteoarthritis
Patients with hand osteoarthritis (HOA) who have or develop diabetes mellitus (DM) and/or cardiovascular disease (CVD) appear to experience a lower likelihood of symptomatic and functional improvement over time, suggests a study. This indicates the effect of comorbid CVD and DM on the clinical and radiographic course of HOA.
This study sought to determine the course of HOA and its association with CVD and DM. The authors collected data at three timepoints from 845 Johnston County Osteoarthritis Project participants (mean age, 60 years; one-third African Americans; two-thirds women) with and without HOA, CVD, or DM.
A diagnosis of radiographic (r)HOA was characterized by a Kellgren-Lawrence severity of ≥2 in at least three joints in each hand. A 4-state progressive model included transitions based on rHOA and pain or function as defined using the Australian/Canadian HOA Index.
The authors then generated Markov multistate models to estimate hazard ratios (HRs) and 95 percent confidence intervals (CIs) for the associations between DM or CVD and specific state transitions, adjusting for baseline and time-varying covariates.
Individuals with DM, compared with those without, tended to have worsening pain with rHOA, while participants who had or developed CVD, compared with those who did not, had a lower likelihood of experiencing symptomatic improvement regardless of rHOA status.
Furthermore, HOA patients with comorbid DM or CVD, compared with those without such comorbidities, were less likely to have functional improvement. However, this finding was statistically significant only for those with DM and no rHOA.
“Additional studies are needed to confirm these findings,” the authors said.