Temporal relationship between osteoarthritis and comorbidities: a combined case control and cohort study in the UK primary care setting. Swain, S., Coupland, C., Mallen, C., Kuo, C. F., Sarmanova, A., Bierma-Zeinstra, S. M. A., Englund, M., Prieto-Alhambra, D., Doherty, M., & Zhang, W. Rheumatology (Oxford, England), 60(9):4327–4339, September, 2021.
Temporal relationship between osteoarthritis and comorbidities: a combined case control and cohort study in the UK primary care setting [link]Paper  doi  abstract   bibtex   
OBJECTIVE: To determine the burden of comorbidities in osteoarthritis (OA) and their temporal relationships in the UK. METHODS: The Clinical Practice Research Datalink (CPRD) GOLD was used to identify people with incident OA and age, gender and practice matched non-OA controls from UK primary care. Controls were assigned the same index date as matched cases (date of OA diagnosis). Associations between OA and 49 individual comorbidities and multimorbidity (≥2 comorbidities excluding OA) both before and after OA diagnosis were estimated, adjusting for covariates, using odds ratios (aOR) and hazard ratios (aHR) respectively. RESULTS: During 1997-2017, we identified 221 807 incident OA cases and 221 807 matched controls. Of 49 comorbidities examined, 38 were associated with OA both prior to, and following, the diagnosis of OA, and 2 (dementia and SLE) were associated with OA only following the diagnosis of OA. People with OA had higher risk of developing heart failure (aHR 1.63; 95% CI 1.56-1.71), dementia (aHR 1.62; 95% CI 1.56-1.68), liver diseases (aHR 1.51; 95% CI 1.37-1.67), irritable bowel syndrome (aHR 1.51; 95% CI 1.45-1.58), gastrointestinal bleeding (aHR 1.49; 95% CI 1.39-1.59), 10 musculoskeletal conditions and 25 other conditions following OA diagnosis. The aOR for multimorbidity prior to the index date was 1.71 (95% CI 1.69-1.74), whereas the aHR for multimorbidity after the index date was 1.29 (95% CI 1.28-1.30). CONCLUSIONS: People with OA are more likely to have other chronic conditions both before and after the OA diagnosis. Further study on shared aetiology and causality of these associations is needed.
@article{swain_temporal_2021,
	title = {Temporal relationship between osteoarthritis and comorbidities: a combined case control and cohort study in the {UK} primary care setting},
	volume = {60},
	issn = {1462-0332},
	shorttitle = {Temporal relationship between osteoarthritis and comorbidities},
	url = {https://doi.org/10.1093/rheumatology/keab067},
	doi = {10.1093/rheumatology/keab067},
	abstract = {OBJECTIVE: To determine the burden of comorbidities in osteoarthritis (OA) and their temporal relationships in the UK.
METHODS: The Clinical Practice Research Datalink (CPRD) GOLD was used to identify people with incident OA and age, gender and practice matched non-OA controls from UK primary care. Controls were assigned the same index date as matched cases (date of OA diagnosis). Associations between OA and 49 individual comorbidities and multimorbidity (≥2 comorbidities excluding OA) both before and after OA diagnosis were estimated, adjusting for covariates, using odds ratios (aOR) and hazard ratios (aHR) respectively.
RESULTS: During 1997-2017, we identified 221 807 incident OA cases and 221 807 matched controls. Of 49 comorbidities examined, 38 were associated with OA both prior to, and following, the diagnosis of OA, and 2 (dementia and SLE) were associated with OA only following the diagnosis of OA. People with OA had higher risk of developing heart failure (aHR 1.63; 95\% CI 1.56-1.71), dementia (aHR 1.62; 95\% CI 1.56-1.68), liver diseases (aHR 1.51; 95\% CI 1.37-1.67), irritable bowel syndrome (aHR 1.51; 95\% CI 1.45-1.58), gastrointestinal bleeding (aHR 1.49; 95\% CI 1.39-1.59), 10 musculoskeletal conditions and 25 other conditions following OA diagnosis. The aOR for multimorbidity prior to the index date was 1.71 (95\% CI 1.69-1.74), whereas the aHR for multimorbidity after the index date was 1.29 (95\% CI 1.28-1.30).
CONCLUSIONS: People with OA are more likely to have other chronic conditions both before and after the OA diagnosis. Further study on shared aetiology and causality of these associations is needed.},
	language = {eng},
	number = {9},
	journal = {Rheumatology (Oxford, England)},
	author = {Swain, Subhashisa and Coupland, Carol and Mallen, Christian and Kuo, Chang Fu and Sarmanova, Aliya and Bierma-Zeinstra, Sita M. A. and Englund, Martin and Prieto-Alhambra, Daniel and Doherty, Michael and Zhang, Weiya},
	month = sep,
	year = {2021},
	pmid = {33506862},
	keywords = {Osteoarthritis, burden, comorbidity, multimorbidity, temporal association},
	pages = {4327--4339},
}

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