Knee osteoarthritis and time-to all-cause mortality in six community-based cohorts: an international meta-analysis of individual participant-level data

<strong>Background:</strong> Osteoarthritis (OA) is a chronic joint disease, with increasing global burden of disability and healthcare utilisation. Recent meta-analyses have shown a range of effects of OA on mortality, reflecting different OA definitions and study methods. We seek to ov...

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Bibliografische gegevens
Hoofdauteurs: Leyland, KM, Gates, LS, Sanchez, M, Nevitt, M, Felson, D, Jones, G, Jordan, JM, Judge, A, Prieto Alhambra, D, Yoshimura, N, Newton, J, Callahan, LF, Cooper, C, Batt, M, Lin, J, Qiang, L, Cleveland, R, Collins, G, Arden, NK
Formaat: Journal article
Taal:English
Gepubliceerd in: Springer 2021
Omschrijving
Samenvatting:<strong>Background:</strong> Osteoarthritis (OA) is a chronic joint disease, with increasing global burden of disability and healthcare utilisation. Recent meta-analyses have shown a range of effects of OA on mortality, reflecting different OA definitions and study methods. We seek to overcome limitations introduced when using aggregate results by gathering individual participant-level data (IPD) from international observational studies and standardising methods to determine the association of knee OA with mortality in the general population. <br> <strong>Methods:</strong> Seven community-based cohorts were identified containing knee OA-related pain, radiographs and time-to-mortality, six of which were available for analysis. A two-stage IPD meta-analysis framework was applied: 1) Cox proportional hazard models assessed time-to-mortality of participants with radiographic OA (ROA), OA-related pain (POA), and a combination of pain and ROA (PROA) against pain and ROA-free participants; 2) hazard ratios (HR) were then pooled using the Hartung-Knapp modification for random effects meta-analysis. <br> <strong>Findings:</strong> 10,723 participants in six cohorts from four countries were included in the analyses. Multivariable models (adjusting for age, sex, race, BMI, smoking, alcohol consumption, cardiovascular disease and diabetes) showed a pooled HR, compared to pain and ROA-free participants, of 1·03 (0·83, 1·28) for ROA, 1·35 (1·12, 1·63) for POA, and 1·37 (1·22, 1·54) for PROA. <br> <strong>Discussion:</strong> Participants with POA or PROA had a 35 to 37% increased association with reduced time-to-mortality, independent of confounders. ROA showed no association with mortality, suggesting that OA-related knee pain may be driving the association with time-to-mortality. <br> <strong>Funding:</strong> Versus Arthritis Centre for Sport, Exercise and Osteoarthritis and Osteoarthritis Research Society International