Comorbidities associated with hand OA disease burden
There are significant associations between comorbidities and hand osteoarthritis (OA) disease burden, a recent study has found.
The authors used cross-sectional data from the Hand Osteoarthritis in Secondary Care (HOSTAS) cohort, including consecutive patients with primary hand OA. A total of 19 comorbidities were evaluated: 18 self-reported (modified Charlson index and osteoporosis) and obesity (body mass index ≥30 kg/m2).
Adjusting for age and sex, mean differences were estimated between patients with vs without comorbidities for the following: general disease burden (health-related quality of life [HRQoL], Medical Outcomes Study Short Form-36 physical component scale [0 to 100]) and disease-specific burden (self-reported hand function [0 to 36], pain [0 to 20; Australian/Canadian Hand OA Index) and tender joint count (TJC; 0 to 30). Those considered clinically relevant were differences above a minimal clinically important improvement.
Overall, 538 patients (mean age 61 years; 86 percent women; 88 percent met the American College of Rheumatology classification criteria) were included in the analysis. Mean HRQoL, function, pain and TJC were 44.7, 15.6, 9.3 and 4.8, respectively.
More than half of the patients (54 percent) had any comorbidity, which was unfavourable (adjusted mean difference presence/absence any comorbidity: HRQoL, ‒4.4; 95 percent CI, ‒5.8 to ‒3.0; function, 1.9; 0.4 to 3.3; pain, 1.4; 0.6 to 2.1; TJC, 1.3; 0.4 to 2.2).
Number of comorbidities, as well as musculoskeletal (eg, connective tissue disease) and nonmusculoskeletal comorbidities (eg, pulmonary and cardiovascular disease), correlated with disease burden. There were also clinically relevant associations with HRQoL and function.
These findings show that “the role of comorbidities in hand OA should be considered when interpreting disease outcomes and in patient management,” according to the authors.