H1-antihistamines are associated with lower prevalence of radiographic knee osteoarthritis: a cross-sectional analysis of the Osteoarthritis Initiative data

Ivan Shirinsky,Valery Shirinsky

doi:10.1186/s13075-018-1619-7

Abstract

BackgroundThere is growing evidence that mast cells (MCs) play a role in knee osteoarthritis (OA). H1-antihistamines block H1-receptors of histamine, which is an important mediator of MCs. There is a lack of data on whether H1-antihistamines can influence OA. We hypothesized that the use of H1-antihistamines may be linked to the reduced prevalence of knee OA.MethodsBaseline data from the Osteoarthritis Initiative cohort were analysed cross-sectionally. Unadjusted and adjusted logistic regression models were performed to compare the prevalence of knee OA in H1-antihistamine users and non-users. Generalized estimating equations were used to adjust for the correlation between knees. Knee OA was defined as (1) Kellgren-Lawrence (KL) grade ≥ 2 or total joint replacement or (2) KL grade ≥ 2 and joint space narrowing or total joint replacement.ResultsThe analysed sample consisted of 8545 knees (664 knees of H1-antihistamine users and 7881 knees of H1-antihistamine non-users). The use of H1-antihistamines was associated with reduced prevalence of knee OA in unadjusted and adjusted models using both the first (adjusted OR, 0.77; 95% CI, 0.62, 0.96; P < 0.02) and second (adjusted OR, 0.75; 95% CI, 0.62, 0.93; P < 0.008) definitions of knee OA.ConclusionsH1-antihistamines are associated with a reduced prevalence of knee OA. The findings indicate that this class of drugs should be further evaluated for possible structure-modifying properties in knee OA.

Highlights

There is growing evidence that mast cells (MCs) play a role in knee osteoarthritis (OA)
In osteoarthritis (OA), MCs are prevalent in synovial tissue, and their presence is associated with structural damage [4]
The prevalence of radiographic knee OA was 15.5% and 10.8% lower in the H1-antihistamine users group using the first and second definitions of radiographic knee OA, respectively. This difference was due to a lower proportion of patients with bilateral knee OA in the H1-antihistamine users group (26.5% and 17% less patients with bilateral knee OA using first and second definitions of knee OA, respectively) (Table 1)

Summary

Introduction

There is growing evidence that mast cells (MCs) play a role in knee osteoarthritis (OA). H1antihistamines block H1-receptors of histamine, which is an important mediator of MCs. There is a lack of data on whether H1-antihistamines can influence OA. We hypothesized that the use of H1-antihistamines may be linked to the reduced prevalence of knee OA. Mast cells (MCs) have long been considered to be inflammatory cells involved primarily in parasitic infections and allergic reactions. In osteoarthritis (OA), MCs are prevalent in synovial tissue, and their presence is associated with structural damage [4]. The primary action of histamine H1-receptor blockers (H1-antihistamines) is to block the effects of H1-antihistamines might be a candidate class of drugs to prevent and treat OA. There is a lack of data on the effects of H1-antihistamines in knee OA in humans. H1-antihistamines were linked to decreased progression and less pain in knee OA [6]

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