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...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Springer
2021
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| _version_ | 1797101322365829120 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Leyland, KM |
| collection | OXFORD |
| description | <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.
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<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.
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<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.
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<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.
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<strong>Funding:</strong> Versus Arthritis Centre for Sport, Exercise and Osteoarthritis and Osteoarthritis Research Society International
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| first_indexed | 2024-03-07T05:50:13Z |
| format | Journal article |
| id | oxford-uuid:e89c7f27-a32d-4bcf-946a-81f18dedba66 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T05:50:13Z |
| publishDate | 2021 |
| publisher | Springer |
| record_format | dspace |
| spelling | oxford-uuid:e89c7f27-a32d-4bcf-946a-81f18dedba662022-03-27T10:48:07ZKnee osteoarthritis and time-to all-cause mortality in six community-based cohorts: an international meta-analysis of individual participant-level dataJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:e89c7f27-a32d-4bcf-946a-81f18dedba66EnglishSymplectic ElementsSpringer2021Leyland, KMGates, LSSanchez, MNevitt, MFelson, DJones, GJordan, JMJudge, APrieto Alhambra, DYoshimura, NNewton, JCallahan, LFCooper, CBatt, MLin, JQiang, LCleveland, RCollins, GArden, NK<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 |
| spellingShingle | 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 Knee osteoarthritis and time-to all-cause mortality in six community-based cohorts: an international meta-analysis of individual participant-level data |
| title | Knee osteoarthritis and time-to all-cause mortality in six community-based cohorts: an international meta-analysis of individual participant-level data |
| title_full | Knee osteoarthritis and time-to all-cause mortality in six community-based cohorts: an international meta-analysis of individual participant-level data |
| title_fullStr | Knee osteoarthritis and time-to all-cause mortality in six community-based cohorts: an international meta-analysis of individual participant-level data |
| title_full_unstemmed | Knee osteoarthritis and time-to all-cause mortality in six community-based cohorts: an international meta-analysis of individual participant-level data |
| title_short | Knee osteoarthritis and time-to all-cause mortality in six community-based cohorts: an international meta-analysis of individual participant-level data |
| title_sort | knee osteoarthritis and time to all cause mortality in six community based cohorts an international meta analysis of individual participant level data |
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