Patients With Rheumatoid Arthritis Increased Risk of Developing Osteoarthritis: A Nationwide Population-Based Cohort Study in Taiwan.

Yung-Heng Lee,Shuo-Yan Gau,James Cheng-Chung Wei,Su-Ling Kao,Hsi-Kai Tsou,Yi-Chiao Bai,Mei-Chen Lin

doi:10.3389/fmed.2020.00392

Abstract

Objective: To investigate the risk of developing OA in patients diagnosed with RA.Methods: In this study, we presented gender, age, urbanization, occupation and, comorbidities in a RA cohort and a non-RA cohort based on number and percentage. We investigated the OA risk in patients with RA. We conducted a retrospective cohort study with a 13-year longitudinal follow-up in Taiwan. Patients who received RA diagnoses between 2000 and 2012 were enrolled in the study cohort. The non-RA cohort were 1:1 propensity score matched with the RA cohort by age, gender, index year, urbanization, occupation, and comorbidities. The hazard ratios (HRs) and adjusted HRs (aHRs) were estimated after confounders were adjusted. Sensitivity analysis utilizing the Longitudinal Health Insurance Database (LHID) was conducted.Results: We totally enrolled 63,626 cases in RA patients (study cohort) and matched controls. In the RA cohort, the crude HR for OA was 2.86 (95% confidence interval (CI), 2.63–3.11, p < 0.001), and the aHR was 2.75 (95% CI, 2.52–2.99, p < 0.001). (The study demonstrated that patients with RA had a higher risk for developing OA compared with the non-RA controls.Conclusion: Developing effective OA prevention strategies are necessary in patients with RA. This finding may be extended to evaluate the risk of OA among other kinds of inflammatory autoimmune diseases. Identifying the key pathogenesis mechanisms are necessary in the future study.

Highlights

Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammation that can cause joint destruction
To explore the association between RA and OA, we recruited a total of 63,626 subjects; of which 31,813 were RA patients and the rest were non-RA patients (Table 1)
Our study demonstrated that diabetes along with a diagnosis of RA had no significantly lower risk compared to the non-RA cohort

Summary

Introduction

Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammation that can cause joint destruction. It may interfere with daily activities and have a serious adverse effect on quality of life [1]. RA is characterized by highly vascularized synovitis, which leads to bone erosion, cartilage damage, and joint destruction [7]. Inflammatory cytokines, such as tumor necrosis factor alpha (TNFα), interleukin (IL)-1, and IL-6, play a crucial role in the pathogenesis of RA [8]

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Discussion

Conclusion