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Kajos LF, Molics B, Elmer D, Pónusz-Kovács D, Kovács B, Horváth L, Csákvári T, Bódis J, Boncz I. Annual epidemiological and health insurance disease burden of hip osteoarthritis in Hungary based on nationwide data. BMC Musculoskelet Disord 2024; 25:406. [PMID: 38783258 PMCID: PMC11112791 DOI: 10.1186/s12891-024-07513-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 05/09/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Health services utilization related to hip osteoarthritis imposes a significant burden on society and health care systems. Our aim was to analyse the epidemiological and health insurance disease burden of hip osteoarthritis in Hungary based on nationwide data. METHODS Data were extracted from the nationwide financial database of the National Health Insurance Fund Administration (NHIFA) of Hungary for the year 2018. The analysed data included annual patient numbers, prevalence, and age-standardized prevalence per 100,000 population in outpatient care, health insurance costs calculated for age groups and sexes for all types of care. Patients with hip osteoarthritis were identified using code M16 of the International Classification of Diseases (ICD), 10th revision. Age-standardised prevalence rates were calculated using the European Standard Population 2013 (ESP2013). RESULTS Based on patient numbers of outpatient care, the prevalence per 100,000 among males was 1,483.7 patients (1.5%), among females 2,905.5 (2.9%), in total 2,226.2 patients (2.2%). The age-standardised prevalence was 1,734.8 (1.7%) for males and 2,594.8 (2.6%) for females per 100,000 population, for a total of 2,237.6 (2.2%). The prevalence per 100,000 population was higher for women in all age groups. In age group 30-39, 40-49, 50-59, 60-69 and 70 + the overall prevalence was 0.2%, 0.8%, 2.7%, 5.0% and 7.7%, respectively, describing a continuously increasing trend. In 2018, the NHIFA spent 42.31 million EUR on the treatment of hip osteoarthritis. Hip osteoarthritis accounts for 1% of total nationwide health insurance expenditures. 36.8% of costs were attributed to the treatment of male patients, and 63.2% to female patients. Acute inpatient care, outpatient care and chronic and rehabilitation inpatient care were the main cost drivers, accounting for 62.7%, 14.6% and 8.2% of the total health care expenditure for men, and 51.0%, 20.0% and 11.2% for women, respectively. The average annual treatment cost per patient was 3,627 EUR for men and 4,194 EUR for women. CONCLUSIONS The prevalence of hip osteoarthritis was 1.96 times higher (the age-standardised prevalence was 1.5 times higher) in women compared to men. Acute inpatient care was the major cost driver in the treatment of hip osteoarthritis. The average annual treatment cost per patient was 15.6% higher for women compared to men.
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Affiliation(s)
- Luca Fanni Kajos
- Institute for Health Insurance, Faculty of Health Sciences, University of Pécs, Pécs, Hungary.
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary.
- National Laboratory On Human Reproduction, University of Pécs, Pécs, Hungary.
| | - Bálint Molics
- Institute of Physiotherapy and Sport Science, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Diána Elmer
- Institute for Health Insurance, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
- National Laboratory On Human Reproduction, University of Pécs, Pécs, Hungary
| | - Dalma Pónusz-Kovács
- Institute for Health Insurance, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
- National Laboratory On Human Reproduction, University of Pécs, Pécs, Hungary
| | - Bettina Kovács
- Institute for Health Insurance, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Lilla Horváth
- Institute for Health Insurance, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Tímea Csákvári
- Institute for Health Insurance, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
- National Laboratory On Human Reproduction, University of Pécs, Pécs, Hungary
| | - József Bódis
- Institute for Health Insurance, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
- National Laboratory On Human Reproduction, University of Pécs, Pécs, Hungary
- Department of Obstetrics and Gynaecology, Clinical Centre, Medical School, University of Pécs, Pécs, Hungary
| | - Imre Boncz
- Institute for Health Insurance, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
- National Laboratory On Human Reproduction, University of Pécs, Pécs, Hungary
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Vina ER, Youk AO, Quinones C, Kwoh CK, Ibrahim SA, Hausmann LRM. Use of Complementary and Alternative Therapy for Knee Osteoarthritis: Race and Gender Variations. ACR Open Rheumatol 2021; 3:660-667. [PMID: 34535982 PMCID: PMC8449036 DOI: 10.1002/acr2.11307] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 11/13/2022] Open
Abstract
Objective To evaluate race and gender variations in complementary and alternative medicine (CAM) use for knee osteoarthritis (OA) (unadjusted and adjusted for demographic and clinical factors). Methods A secondary analysis of cross‐sectional data was conducted. The sample included Veterans Affairs patients 50 years of age or older with symptomatic knee OA. Current use of various CAM therapies was assessed at baseline. Logistic regression models were used to compare race and gender differences in the use of specific CAMs. Results The sample included 517 participants (52.2% identified as African American [AA]; 27.1% identified as female). After adjusting for demographic and clinical factors, AA participants, compared with white participants, were less likely to use joint supplements (odds ratio [OR]: 0.53; 95% confidence interval [CI], 0.31‐0.90]); yoga, tai chi, or pilates (OR: 0.39; 95% CI: 0.19‐0.77); and chiropractic care (OR: 0.51; 95% CI: 0.26‐1.00). However, they were more likely to participate in spiritual activities (OR: 2.02; 95% CI: 1.39‐2.94). Women, compared with men, were more likely to use herbs (OR: 2.42; 95% CI: 1.41‐4.14); yoga, tai chi, or pilates (OR: 2.09; 95% CI: 1.04‐4.19); acupuncture, acupressure, or massage (OR: 2.45; 95% CI: 1.28‐4.67); and spiritual activities (OR: 1.68; 95% CI: 1.09‐2.60). The interactive effects of race and gender were significant in the use of herbs (P = 0.008); yoga, tai chi, or pilates (P = 0.011); acupuncture, acupressure or massage (P = 0.038); and spiritual activities (P < 0.001). Conclusion There are race and gender differences in the use of various CAMs for OA. As benefits and limitations of CAM therapies vary, clinicians must be aware of these differences.
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Affiliation(s)
- Ernest R Vina
- College of Medicine and University of Arizona Arthritis Center, University of Arizona, Tucson
| | - Ada O Youk
- Veterans Affairs Pittsburgh Healthcare System and University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Cristian Quinones
- College of Medicine and University of Arizona Arthritis Center, University of Arizona, Tucson
| | - C Kent Kwoh
- College of Medicine and University of Arizona Arthritis Center, University of Arizona, Tucson
| | | | - Leslie R M Hausmann
- Veterans Affairs Pittsburgh Healthcare System and University of Pittsburgh, Pittsburgh, Pennsylvania
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3
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Siviero P, Limongi F, Gesmundo A, Zambon S, Cooper C, Dennison EM, Edwards MH, van der Pas S, Timmermans EJ, van Schoor NM, Schaap LA, Dallmeier D, Denkinger MD, Peter R, Castell MV, Otero Á, Pedersen NL, Deeg DJH, Maggi S. Factors Associated With Functional Decline in Hand and Hip/Knee Osteoarthritis After One Year: Data From a Population-Based Study. Arthritis Care Res (Hoboken) 2021; 73:1343-1353. [PMID: 32770733 DOI: 10.1002/acr.24404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 07/30/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate factors that together with hand or hip/knee osteoarthritis (OA) could contribute to functional decline over a year's time in elderly individuals. METHODS The data of 1,886 individuals between ages 65 and 85 years in a prospective, observational population-based study with 12-18 months of follow-up in the context of the European Project on Osteoarthritis were analyzed. The outcome measures were self-reported hand and hip/knee functional decline, evaluated using a minimum clinically important difference of 4 on the Australian/Canadian Hand OA Index and of 2 on the Western Ontario and McMaster Universities Osteoarthritis Index hip/knee physical function subscales, both normalized to 0-100. Using regression models adjusted for sex, age, country, and education level, the baseline factors considered were clinical hand or hip/knee OA, pain, analgesic/antiinflammatory medications, comorbidities, social isolation, income, walking time, grip strength, physical activity time, and medical/social care. RESULTS After a year, 453 participants were identified as having worse hand functionality and 1,389 as not worse. Hand OA, anxiety, walking time, and grip strength were risk factors for hand functional decline; pain was a confounder of the effect of hand OA. Analgesic/antiinflammatory medications mediated the combined effect of hip/knee OA plus pain on functional decline in the 554 individuals classified as having worse hip/knee functionality and the 1,291 persons who were not worse. Peripheral artery disease, obesity, and cognitive impairment were other baseline risk factors. CONCLUSION Study findings showed that together with emotional status and chronic physical and cognitive conditions, OA affects hand and hip/knee functional decline.
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Affiliation(s)
| | | | - Antonella Gesmundo
- University of Padua, Padua, and Ospedale Riabilitativo di Alta Specializzazione, Motta di Livenza, Treviso, Italy
| | | | - Cyrus Cooper
- University of Southampton and Southampton General Hospital, Southampton, UK
| | - Elaine M Dennison
- University of Southampton and Southampton General Hospital, Southampton, UK
| | - Mark H Edwards
- University of Southampton and Southampton General Hospital, Southampton, and Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | - Suzan van der Pas
- Amsterdam UMC, Amsterdam Public Health Research Institute, and VU University Medical Center, Amsterdam, The Netherlands
| | - Erik J Timmermans
- Amsterdam UMC, Amsterdam Public Health Research Institute, and VU University Medical Center, Amsterdam, The Netherlands
| | - Natasja M van Schoor
- Amsterdam UMC, Amsterdam Public Health Research Institute, and VU University Medical Center, Amsterdam, The Netherlands
| | - Laura A Schaap
- Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | | | | | | | - Ángel Otero
- Universidad Autonoma de Madrid, Madrid, Spain
| | | | - Dorly J H Deeg
- Amsterdam UMC, Amsterdam Public Health Research Institute, and VU University Medical Center, Amsterdam, The Netherlands
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Javadinia SA, Nazeminezhad N, Ghahramani-Asl R, Soroosh D, Fazilat-Panah D, PeyroShabany B, Saberhosseini SN, Mehrabian A, Taghizadeh-Hesary F, Nematshahi M, Dhawan G, Welsh JS, Calabrese EJ, Kapoor R. Low-dose radiation therapy for osteoarthritis and enthesopathies: a review of current data. Int J Radiat Biol 2021; 97:1352-1367. [PMID: 34259615 DOI: 10.1080/09553002.2021.1956000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Osteoarthritis (OA), the most common degenerative joint disease, is associated with severe functional limitation and impairment of quality of life. Numerous reports have documented the clinical efficacy of low-dose radiotherapy (LD-RT) in the management of various inflammatory disorders, including OA. In this paper, we assessed the clinical literature involving the use of LD-RT in the treatment of OA, its dose-response features, possible underlying mechanistic features, and optimal therapeutic dose range. METHODS We carried out a systematic review based on the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statements and evaluated articles meeting the inclusion criteria for this review. RESULTS A total of 361 articles were identified from databases, such as Scopus, PubMed, Embase, and Science Direct out of which 224 articles were duplicates and were discarded. Of the remaining 137 articles, 74 articles were un-related, 27 articles were review articles, eight were conference abstracts, three were letters, two were editorials, two were notes, and one was a book chapter. Finally, 20 articles met all the inclusion criteria and were included in this systematic review. DISCUSSION Several single-arm retrospective/prospective studies showed advantages for LD-RT in the management of OA in terms of pain relief, improvement of mobility and function, and showed minimal side effects. Mechanistic considerations involve positive subcellular effects mediated by the activation of a nuclear factor erythroid 2-related transcription factor (Nrf2) mediated antioxidant response. Further research on both the short- and long-term effects of LD-RT on OA and other inflammatory disorders is recommended.
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Affiliation(s)
- Seyed Alireza Javadinia
- Clinical Research Development Unit, Hospital Research Development Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | | | - Ruhollah Ghahramani-Asl
- Clinical Research Development Unit, Hospital Research Development Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Davood Soroosh
- Clinical Research Development Unit, Hospital Research Development Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | | | - Babak PeyroShabany
- Department of Internal Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | | | - Arezoo Mehrabian
- Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Nematshahi
- Department of Anesthesiology and Critical Care, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Gaurav Dhawan
- Sri Guru Ram Das University of Health Sciences, Amritsar, India
| | - James S Welsh
- Edward Hines Jr. VA Hospital, Loyola University Chicago Stritch School of Medicine, Chicago, IL, USA
| | - Edward J Calabrese
- Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - Rachna Kapoor
- Saint Francis Hospital and Medical Center, Hartford, CT, USA
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5
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Molecular Mechanisms of Sex-Related Differences in Arthritis and Associated Pain. Int J Mol Sci 2020; 21:ijms21217938. [PMID: 33114670 PMCID: PMC7663489 DOI: 10.3390/ijms21217938] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/02/2020] [Accepted: 10/21/2020] [Indexed: 12/12/2022] Open
Abstract
Clinical conditions leading to chronic pain show important sex-related differences in the prevalence, severity, and degree of functional disability. Decades of epidemiological and clinical studies have demonstrated that women are more sensitive to pain than men. Arthritis, including rheumatoid arthritis (RA) and osteoarthritis (OA), is much more prevalent in females and accounts for the majority of pain arising from musculoskeletal conditions. It is therefore important to understand the mechanisms governing sex-dependent differences in chronic pain, including arthritis pain. However, research into the mechanisms underlying the sex-related differences in arthritis-induced pain is still in its infancy due to the bias in biomedical research performed largely in male subjects and animals. In this review, we discuss current advances in both clinical and preclinical research regarding sex-related differences in the development or severity of arthritis and associated pain. In addition, sex-related differences in biological and molecular mechanisms underlying the pathogenesis of arthritis pain, elucidated based on clinical and preclinical findings, are reviewed.
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Saviola G, Ferrari P, Niccolò E, Casabella A, Ghellere F, Bonazzi S, Lul AA, Comini L, Molfetta L. Use of clodronate for painful knee prosthesis in osteoarthritis patients: a 6-month pilot study. Minerva Med 2020; 111:551-559. [PMID: 32573517 DOI: 10.23736/s0026-4806.20.06706-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Knee replacement surgery is one of the most common surgical procedures performed worldwide. Unfortunately, knee prostheses can become painful over time, necessitating appropriate analgesic treatment. Bisphosphonates such as clodronate (CLO) may play an important role in the treatment of painful knee prostheses by virtue of its analgesic and anti-inflammatory properties. METHODS In this prospective open label pilot study, eighteen consecutive patients aged 73.2±8.9 years affected by knee painful prosthesis and osteoarthritis were treated with a rehabilitation cycle in addition to i.v. or i.m. CLO. Induction dose was 2.0-2.1g, followed by a weekly dose of 200 mg (i.m.) for 6 months. Visual analogue scale (VAS) pain score and Tegner Lysholm Score (TLS) were used to assess improvement following CLO treatment. RESULTS Thirteen out of 18 patients completed the 6-month follow-up. VAS pain score decreased from 8.1±1.8 at baseline to 5.6±2.6 (P<0.05) and TLS increased from 40.4±20.3 at baseline to 62.7±24.1 at 6 months (P<0.05). Univariate regression revealed that among a range of variables, BMI was positively correlated with VAS (r=0.73, P=0.004) and lower TLS after 1 month (r= -0.62, P=0.006). CONCLUSIONS CLO in association with rehabilitation exercises can reduce pain and ameliorate the functionality of painful knee prostheses. Administration of a high dose (induction dose) of CLO every 3 months appears to be the most effective regimen compared to a weekly maintenance dose.
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Affiliation(s)
- Gianantonio Saviola
- Unit of Rheumatology and Rehabilitation, Institute of Castel Goffredo, IRCCS Maugeri Clinical Scientific Institutes, Mantua, Italy -
| | - Paolo Ferrari
- Unit of Orthopedics, San Pellegrino Hospital, Castiglione delle Stiviere, Mantua, Italy
| | - Ernesto Niccolò
- Unit of Orthopedics, San Pellegrino Hospital, Castiglione delle Stiviere, Mantua, Italy
| | - Andrea Casabella
- School of Medical and Pharmaceutical Sciences, Research Center of Osteoporosis and Osteoarticular Pathologies, University of Genoa, Genoa, Italy
| | - Francesco Ghellere
- Unit of Rheumatology and Rehabilitation, Institute of Castel Goffredo, IRCCS Maugeri Clinical Scientific Institutes, Mantua, Italy.,Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Sonia Bonazzi
- Unit of Rheumatology and Rehabilitation, Institute of Castel Goffredo, IRCCS Maugeri Clinical Scientific Institutes, Mantua, Italy
| | - Abdi-Ali Lul
- Unit of Rheumatology and Rehabilitation, Institute of Castel Goffredo, IRCCS Maugeri Clinical Scientific Institutes, Mantua, Italy
| | - Laura Comini
- Scientific Direction of the Institute of Lumezzane, IRCCS Maugeri Clinical Scientific Institutes, Brescia, Italy
| | - Luigi Molfetta
- School of Medical and Pharmaceutical Sciences, Research Center of Osteoporosis and Osteoarticular Pathologies, University of Genoa, Genoa, Italy
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Stoffer-Marx MA, Klinger M, Luschin S, Meriaux-Kratochvila S, Zettel-Tomenendal M, Nell-Duxneuner V, Zwerina J, Kjeken I, Hackl M, Öhlinger S, Woolf A, Redlich K, Smolen JS, Stamm TA. Functional consultation and exercises improve grip strength in osteoarthritis of the hand - a randomised controlled trial. Arthritis Res Ther 2018; 20:253. [PMID: 30413191 PMCID: PMC6235228 DOI: 10.1186/s13075-018-1747-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 10/15/2018] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Evidence for non-pharmacological interventions in hand osteoarthritis is promising but still scarce. Combined interventions are most likely to best cover the clinical needs of patients with hand osteoarthritis (OA). The aim of this study was to evaluate the effect of a combined, interdisciplinary intervention feasible in both primary and specialist care compared to routine care plus placebo in patients with hand OA. METHODS This was a randomised, controlled 2-month trial with a blinded assessor. In the combined-intervention group, rheumatology-trained health professionals from different disciplines delivered a one-session individual intervention with detailed information on functioning, activities of daily living, physical activity, nutrition, assistive devices, instructions on pain management and exercises. Telephone follow up was performed after 4 weeks. The primary outcome was grip strength after 8 weeks. Secondary outcomes were self-reported pain, satisfaction with treatment, health status, two of the Jebsen-Taylor Hand Function subtests and the total score of the Australian/Canadian Hand Osteoarthritis Index (AUSCAN). Statistical significance was calculated by Student's t test or the Mann-Whitney U test depending on data distribution. Binominal logistic regression models were fitted, with the primary outcome being the dependent and the group allocation being the independent variable. RESULTS There were 151 participating patients (74 in the combined-intervention and 77 in the routine-care-plus-placebo group) with 2-month follow-up attendance of 84% (n = 128). Grip strength significantly increased in the combined-intervention group and decreased in the routine-care group (dominant hand, mean 0.03 bar (SD 0.11) versus - 0.03 (SD 0.13), p value = 0.001, baseline corrected values) after 8 weeks. CONCLUSION The combined one-session individual intervention significantly improved grip strength and self-reported satisfaction with treatment in patients with hand OA. It can be delivered by different rheumatology-trained health professionals and is thus also feasible in primary care. TRIAL REGISTRATION ISRCTN registry, ISRCTN62513257 . Registered on 17 May 2012.
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Affiliation(s)
- Michaela A Stoffer-Marx
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.,Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria
| | - Meike Klinger
- Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria.,Department of Health Sciences, University of Applied Sciences FH Campus Wien, Favoritenstraße 226, 1100, Vienna, Austria
| | - Simone Luschin
- Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria.,Department of Health Sciences, University of Applied Sciences FH Campus Wien, Favoritenstraße 226, 1100, Vienna, Austria
| | - Silvia Meriaux-Kratochvila
- Department of Health Sciences, University of Applied Sciences FH Campus Wien, Favoritenstraße 226, 1100, Vienna, Austria.,Physio Austria, Lange Gasse 30/1, Vienna, Austria
| | - Monika Zettel-Tomenendal
- Department of Health Sciences, University of Applied Sciences FH Campus Wien, Favoritenstraße 226, 1100, Vienna, Austria
| | - Valerie Nell-Duxneuner
- Klinikum Peterhof of NOEGKK with Ludwig Boltzmann Department of Epidemiology of Rheumatic Diseases, Sauerhofstraße 9-15, Baden bei Wien, Austria
| | - Jochen Zwerina
- Ludwig Boltzmann Institute of Osteology, 1st Medical Department at Hanusch Hospital, Hanusch Hospital of the WGKK and AUVA Trauma Center, Heinrich Collin Str. 30, 1140, Vienna, Austria
| | - Ingvild Kjeken
- National advisory unit on rehabilitation in rheumatology, Department of rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,Program of Occupational Therapy, Prosthetics and Orthotics, Oslo Metropolitan University, Oslo, Norway
| | - Marion Hackl
- Ergotherapie Austria, Bundesverband der Ergotherapeutinnen und Ergotherapeuten Österreichs, Holzmeistergasse 7-9/2/1, Vienna, Austria
| | - Sylvia Öhlinger
- University of Applied Sciences for Health Professions Upper Austria, Semmelweisstraße 34, Linz, Austria
| | - Anthony Woolf
- Bone and Joint Research Group, Royal Cornwall Hospital, Truro, UK
| | - Kurt Redlich
- Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria
| | - Josef S Smolen
- Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria
| | - Tanja A Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
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Presence of comorbidities and prognosis of clinical symptoms in knee and/or hip osteoarthritis: A systematic review and meta-analysis. Semin Arthritis Rheum 2018; 47:805-813. [DOI: 10.1016/j.semarthrit.2017.10.016] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 09/26/2017] [Accepted: 10/23/2017] [Indexed: 02/06/2023]
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9
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Williams MF, London DA, Husni EM, Navaneethan S, Kashyap SR. Type 2 diabetes and osteoarthritis: a systematic review and meta-analysis. J Diabetes Complications 2016; 30:944-50. [PMID: 27114387 DOI: 10.1016/j.jdiacomp.2016.02.016] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 02/15/2016] [Accepted: 02/18/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND Observational studies have reported an association between type 2 diabetes and osteoarthritis (OA) development and progression. However no systematic review of the literature exists assessing whether this association is consistently true. We aimed to systematically review the association between type 2 diabetes and the presence, development, and progression of OA. METHODS We searched MEDLINE, SCOPUS, EMBASE, the Web of Science, and Grey Literature (through August 2014) for prospective cohort, cross-sectional, and case-control studies with confidence intervals (CI) that reported an association between type 2 diabetes and impaired glucose tolerance (IGT) and the development or presence of OA of any joint. RESULTS Ten studies and fourteen ratios were included in the analysis. The pooled population size in our meta-regression was 16,742 patients. Type 2 diabetes was significantly associated with the development or presence of OA (OR; 1·21, 95% CI: 1·02-1·41). In the subset of 7 studies that did control for weight or BMI there was an increased odds of OA associated with type 2 diabetes was (OR: 1·25, 95% CI: 1·05-1·46) from a smaller pool of patients (n=7156). CONCLUSIONS Type 2 diabetes is associated with the development and presence of radiographic and symptomatic OA even when controlling for body mass index and weight.
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Affiliation(s)
- Mia F Williams
- University of California San Francisco, Internal Medicine Residency, 505 Parnassus Avenue, San Francisco, CA 94143-0119
| | | | - Elaine M Husni
- Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195
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Moe RH, Grotle M, Kjeken I, Olsen IC, Mowinckel P, Haavardsholm EA, Hagen KB, Kvien TK, Uhlig T. Effectiveness of an Integrated Multidisciplinary Osteoarthritis Outpatient Program versus Outpatient Clinic as Usual: A Randomized Controlled Trial. J Rheumatol 2015; 43:411-8. [DOI: 10.3899/jrheum.150157] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2015] [Indexed: 12/24/2022]
Abstract
Objective.Osteoarthritis (OA) is one of the leading causes of pain and disability. Given the constraint in the provision of care, there is a need to develop and assess effectiveness of new treatment models. The objective was to compare satisfaction with and effectiveness of a new integrated multidisciplinary outpatient program with usual care in an outpatient clinic for patients with OA.Methods.Patients with clinical OA referred to a rheumatology outpatient clinic were randomized to a 3.5-h multidisciplinary group-based educational program followed by individual consultations, or to usual care. The primary outcome was satisfaction with the health service evaluated on a numerical rating scale (0 = extremely unsatisfied, 10 = extremely satisfied) after 4 months. Secondary outcomes included health-related quality of life measures.Results.Of 391 patients, 86.4% (n = 338) were women, and mean age was 61.2 (SD 8.0) years. At 4 months, patients who received integrated multidisciplinary care were significantly more satisfied with the health service compared with controls, with a mean difference of −1.05 (95% CI −1.68 to −0.43, p < 0.001). Among secondary outcomes, only self-efficacy with other symptoms scale (10–100) improved significantly in the multidisciplinary group compared with controls at 4 months (3.59, 95% CI 0.69–6.5, p = 0.02). At 12 months, the Australian/Canadian Hand Osteoarthritis Index pain (0–10) and fatigue scores (0–10) were slightly worse in the multidisciplinary group with differences of 0.38 (95% CI 0.06–0.71, p = 0.02) and 0.55 (95% CI 0.02–1.07, p = 0.04), respectively.Conclusion.Patients receiving an integrated multidisciplinary care model were more satisfied with healthcare than those receiving usual care, whereas there were no clinically relevant improvements in health outcomes.
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Carvalho RTD, Santos Neto DB, Chammas V, Arrebola LS, Colombo ML, Scalizi Junior C. Influence of body mass index in revision total knee arthroplasty. ACTA ORTOPEDICA BRASILEIRA 2015; 23:290-3. [PMID: 27057139 PMCID: PMC4775503 DOI: 10.1590/1413-785220152306140199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE : To evaluate the influence of the body mass index (BMI) on the functional assessment of patients who underwent revision total knee arthroplasty (RTKA). METHODS : Thirty patients who un-derwent RTKA between January 2008 and January 2012 were retrospectively assessed using the WOMAC questionnaire. The patients were divided into three groups according to the BMI ca-tegories defined by the World Health Organization (WHO): Group I with normal BMI (18-24.9 Kg/m2), with eight patients; Group II, overweight (BMI 25-29.9 Kg/m2), with 15 patients, and Group III obesity with BMI ≥ 30 Kg/m2, with seven patients. The post-ope-rative function scores obtained through the WOMAC questionnaire were compared with the BMI of each group. The statistical analysis between BMI and WOMAC scores was performed with the Spe-arman correlation test. RESULTS : The average functional WOMAC score for individuals in Group I was 16.7; in Group II it was 47.7; and in Group III it was 69.9, with a statistically significant differen-ce between groups I, II and III (p< 0.0001). CONCLUSION : Patients with BMI > 25 Kg/m2 had a worse functional evaluation through WOMAC scores when compared to patients with normal BMI after RTKA. Level of Evidence III, Tranversal Retrospective Study.
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Louati K, Vidal C, Berenbaum F, Sellam J. Association between diabetes mellitus and osteoarthritis: systematic literature review and meta-analysis. RMD Open 2015; 1:e000077. [PMID: 26535137 PMCID: PMC4613158 DOI: 10.1136/rmdopen-2015-000077] [Citation(s) in RCA: 193] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 03/16/2015] [Accepted: 03/17/2015] [Indexed: 01/02/2023] Open
Abstract
Objectives To investigate the prevalence of osteoarthritis (OA) in patients with diabetes mellitus (DM) and prevalence of DM in patients with OA and whether OA and DM are associated. Design A systematic literature review and meta-analysis. We included cohort, case–control and cross-sectional studies assessing the number of patients with DM and/or OA. The mean prevalence of OA among patients with DM and DM among patients with OA was calculated. Data from trials assessing an association of diabetes and OA were pooled and results are presented as unadjusted OR and 95% CI. Results From the 299 publications, we included 49 studies in the analysis, including 28 cross-sectional studies, 11 cohort studies and 10 case–control studies. In all, 21, 5 and 23 articles involved patients with OA exclusively, patients with DM and the general population, respectively. For 5788 patients with DM, the mean OA prevalence was 29.5±1.2%. For 645 089 patients with OA, the prevalence of DM was 14.4±0.1%. The risk of OA was greater in the DM than non-DM population (OR=1.46 (1.08 to 1.96), p=0.01), as was DM in the OA than non-OA population (OR=1.41 (1.21 to 1.65), p<0.00 001). Among the 12 studies reporting an OR adjusted on at least the body mass index, 5 showed no association of DM and OA and 7 identified DM as an independent risk factor. Conclusions This meta-analysis highlights a high frequency of OA in patients with DM and an association between both diseases, representing a further step towards the individualisation of DM-related OA within a metabolic OA phenotype.
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Affiliation(s)
- Karine Louati
- Department of Rheumatology , Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Antoine Hospital , Paris , France ; Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Paris , France ; Sorbonne Universités, UPMC Univ Paris 06 , Paris , France
| | - Céline Vidal
- Department of Rheumatology , Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Antoine Hospital , Paris , France ; Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Paris , France
| | - Francis Berenbaum
- Department of Rheumatology , Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Antoine Hospital , Paris , France ; Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Paris , France ; Sorbonne Universités, UPMC Univ Paris 06 , Paris , France ; Faculté de Médecine Saint Antoine , INSERM UMR_S 938 , Paris , France
| | - Jérémie Sellam
- Department of Rheumatology , Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Antoine Hospital , Paris , France ; Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Paris , France ; Sorbonne Universités, UPMC Univ Paris 06 , Paris , France ; Faculté de Médecine Saint Antoine , INSERM UMR_S 938 , Paris , France
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Burgos-Vargas R, Cardiel MH, Loyola-Sánchez A, De Abreu MM, Pons-Estel BA, Rossignol M, Avouac B, Ferraz MB, Halhol H. Characterization of Knee Osteoarthritis in Latin America. A Comparative Analysis of Clinical and Health Care Utilization in Argentina, Brazil, and Mexico. ACTA ACUST UNITED AC 2014; 10:152-9. [DOI: 10.1016/j.reuma.2013.07.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 06/14/2013] [Accepted: 07/14/2013] [Indexed: 10/26/2022]
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Functional evaluation of the joints in acromegalic patients and associated factors. Clin Rheumatol 2013; 32:991-8. [DOI: 10.1007/s10067-013-2219-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 02/03/2013] [Accepted: 02/21/2013] [Indexed: 10/27/2022]
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M Hawamdeh Z, Al-Ajlouni JM. The clinical pattern of knee osteoarthritis in Jordan: a hospital based study. Int J Med Sci 2013; 10:790-5. [PMID: 23630445 PMCID: PMC3638304 DOI: 10.7150/ijms.5140] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Accepted: 02/22/2013] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Different clinical profiles of knee osteoarthritis (KOA) have been reported in the literature. The aim of this investigation was to describe the clinical patterns of KOA in an ethnically distinct and homogenous population that has not been widely reported. Patients with KOA were seen in outpatient rehabilitation and orthopedic clinic of Jordan University Hospital (JUH), to determine any possible association between age, BMI, radiographic severity, and pain severity. METHODS Patients diagnosed with KOA attending an outpatient rehabilitation clinic at JUH were studied to describe their clinical characteristics. They were included based on criteria developed by the American College of Rheumatology. Detailed histories, clinical examinations and X-rays, and anthropometric data were obtained. Data analysis focused on descriptive statistics and correlations among demographic and clinical characteristics. RESULTS The study included 214 patients with a mean age of 55.3 years (range = 30-84 years). The mean BMI was 29.5± 5.6. We found a significant moderate positive correlation between age and radiographic severity of KOA (0.435; p <. 001) and pain severity (0.383; p. <. 001). There was also a significant weak positive correlation between BMI, radiographic severity of KOA (0.242, p <. 05), and pain severity (0.266, p. <. 01). CONCLUSIONS We concluded that in this hospital-based cohort study in Jordan, the clinical pattern of KOA is comparable to Western cultures. However, the combination of BMI and mechanical loading during everyday activities that include different religious and cultural habits and may help explain the high level of radiographic severity in our sample.
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Affiliation(s)
- Ziad M Hawamdeh
- Faculty of Rehabilitation Sciences, The University of Jordan, Amman, Jordan.
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Jawahar R, Yang S, Eaton CB, McAlindon T, Lapane KL. Gender-specific correlates of complementary and alternative medicine use for knee osteoarthritis. J Womens Health (Larchmt) 2012; 21:1091-9. [PMID: 22946630 DOI: 10.1089/jwh.2011.3434] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Knee osteoarthritis (OA) increases healthcare use and cost. Women have higher pain and lower quality of life measures compared to men even after accounting for differences in age, body mass index (BMI), and radiographic OA severity. Our objective was to describe gender-specific correlates of complementary and alternative medicine (CAM) use among persons with radiographically confirmed knee OA. METHODS Using data from the Osteoarthritis Initiative, 2,679 women and men with radiographic tibiofemoral OA in at least one knee were identified. Treatment approaches were classified as current CAM therapy (alternative medical systems, mind-body interventions, manipulation and body-based methods, energy therapies, and three types of biologically based therapies) or conventional medication use (over-the-counter or prescription). Gender-specific multivariable logistic regression models identified sociodemographic and clinical/functional correlates of CAM use. RESULTS CAM use, either alone (23.9% women, 21.9% men) or with conventional medications (27.3% women, 19.0% men), was common. Glucosamine use (27.2% women, 28.2% men) and chondroitin sulfate use (24.8% women; 25.7% men) did not differ by gender. Compared to men, women were more likely to report use of mind-body interventions (14.1% vs. 5.7%), topical agents (16.1% vs. 9.5%), and concurrent CAM strategies (18.0% vs. 9.9%). Higher quality of life measures and physical function indices in women were inversely associated with any therapy, and higher pain scores were positively associated with conventional medication use. History of hip replacement was a strong correlate of conventional medication use in women but not in men. CONCLUSIONS Women were more likely than men to use CAM alone or concomitantly with conventional medications.
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Affiliation(s)
- Rachel Jawahar
- Department of Epidemiology and Community Health, Virginia Commonwealth University, Richmond, VA 23219, USA.
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Ding H, Solovieva S, Leino-Arjas P. Determinants of incident and persistent finger joint pain during a five-year followup among female dentists and teachers. Arthritis Care Res (Hoboken) 2011; 63:702-10. [PMID: 21309003 DOI: 10.1002/acr.20437] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To investigate the association of radiographic finger osteoarthritis (OA), hand use, and lifestyle factors with incident and persistent finger joint pain among female dentists and teachers. METHODS Random samples of female dentists (n = 295) and teachers (n = 248) ages 45-63 years were examined by radiography for the presence of finger joint OA. Body weight was measured. Information on finger joint pain during the past 30 days, height, smoking, and leisure-time hand activity was collected by questionnaire. Five years later, 482 women (89%; 65% still active occupationally) responded to a survey on finger joint pain. RESULTS The incidence and persistence of finger joint pain were higher among the subjects with OA compared to those without OA. The relative risk (RR) of incident pain in the first through the third fingers was 1.8 (95% confidence interval [95% CI] 1.2-2.7) in the right hand and the RR in the left hand was 3.0 (95% CI 2.0-4.6), allowing for age, occupation, and lifestyle factors. The corresponding figures for the fourth and fifth fingers were RR 2.3 (95% CI 1.4-3.8) in the right and RR 1.9 (95% CI 1.1-3.5) in the left hand. Regarding persistent pain, the RRs varied between 2.4 and 5.4. Body mass index, smoking, or leisure-time hand activity were not associated with pain. The dentists tended to have a higher incidence of pain in the first through the third fingers of the right hand compared with the teachers. CONCLUSION Radiographic finger joint OA was a significant determinant of both persistent and incident finger joint pain in a 5-year followup among middle-aged women. Hand use may modify the association between radiographic OA and finger joint pain.
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Affiliation(s)
- Hebo Ding
- Finnish Institute of Occupational Health, Helsinki, Finland
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Safety issues in the development of treatments for osteoarthritis: recommendations of the Safety Considerations Working Group. Osteoarthritis Cartilage 2011; 19:493-9. [PMID: 21396471 DOI: 10.1016/j.joca.2011.02.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2010] [Revised: 02/04/2011] [Accepted: 02/08/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The symptomatic treatment of osteoarthritis (OA) remains to be improved, as many patients do not respond well to current palliative therapies and/or suffer unacceptable adverse events. Given the unmet need for innovative, effective and well-tolerated therapies, it is important to develop the means to estimate the ongoing safety profile of novel therapeutic agents over short- and longer term use. DESIGN Methods are presented to estimate the number of serious adverse events (SAEs) of interest considered as "acceptable" per 1000 patient-years exposure and to estimate the numbers of patient-years needed in a randomized controlled trial (RCT) to meet objectives. As exposure is increased, more evidence is accrued that the overall risk is within study limits. It is equally important that requirements for delineating the safety of promising new therapies not create barriers that would preclude their development. Therefore, ongoing surveillance of occurrence of SAEs of interest during clinical development is proposed, for example after every incremental 500 patient-years exposure are accrued. RESULTS This paper and others in this special issue focus on identification of safety signals for symptomatic treatments of OA. Much less information is available for agents aimed at slowing/preventing structural progression but it is expected that a higher risk profile might be considered acceptable in the context of more promising benefit. CONCLUSION This paper provides a proposal and supporting data for a comprehensive approach for assessing ongoing safety during clinical development of both palliative and disease-modifying therapies for OA.
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Methodologic issues in clinical trials for prevention or risk reduction in osteoarthritis. Osteoarthritis Cartilage 2011; 19:500-8. [PMID: 21396470 PMCID: PMC3260468 DOI: 10.1016/j.joca.2010.10.031] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2010] [Revised: 09/23/2010] [Accepted: 10/26/2010] [Indexed: 02/02/2023]
Abstract
The design and execution of prevention trials for OA have methodological issues that are distinct from trials designed to impact prevalent disease. Disease definitions and their precise and sensitive measurement, identification of high-risk populations, the nature of the intervention (pharmaceutical, nutraceutical, behavioral) and its potential pleiotropic impacts on other organ systems are critical to consider. Because prevention trials may be prolonged, close attention to concomitant life changes and co-morbidities, adherence and participant retention in the trial is of primary importance, as is recognition of the potential for "preventive misconception" and "behavioral disinhibition" to affect the ability of the trial to show an effect of the intervention under study. None of these potential pitfalls precludes a successful and scientifically rigorous process and outcome. As technology improves the means to measure and predict the OA process and its clinical consequences, it will be increasingly possible to screen individuals for high-risk phenotypes, combining clinical factors with information from imaging, genetic, metabolic and other biomarkers and to impact this high-risk condition to avoid or delay OA both structurally and symptomatically.
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Baerwald C, Verdecchia P, Duquesroix B, Frayssinet H, Ferreira T. Efficacy, safety, and effects on blood pressure of naproxcinod 750 mg twice daily compared with placebo and naproxen 500 mg twice daily in patients with osteoarthritis of the hip: a randomized, double-blind, parallel-group, multicenter study. ACTA ACUST UNITED AC 2011; 62:3635-44. [PMID: 20722026 DOI: 10.1002/art.27694] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To test the superiority of naproxcinod compared with placebo in relieving the signs and symptoms of hip osteoarthritis and to assess the safety of naproxcinod and its effects on blood pressure. METHODS In a 13-week, randomized, double-blind, parallel-group, multicenter study, 810 patients were randomized to receive either naproxcinod 750 mg twice daily, placebo, or naproxen 500 mg twice daily (2:2:1). Primary efficacy analyses compared naproxcinod and placebo using an analysis of covariance for 3 co-primary end points (the Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] pain and function subscales and patient's overall rating of disease status). Safety assessments included adverse events and in-office blood pressure measurements. RESULTS The least squares mean changes from baseline were significantly greater with naproxcinod than with placebo (P < 0.0001) and were similar to those with naproxen at week 13 for the WOMAC pain score (-25.81, -17.97, and -24.31 mm, respectively), the WOMAC function score (-22.24, -13.45, and -21.67 mm, respectively), and patient's rating of disease status (0.86, 0.51, and 0.82, respectively). Changes from baseline in systolic blood pressure were similar in the naproxcinod and placebo groups at weeks 2, 6, and 13 (differences between groups of 0.25, -0.45, and -0.11 mm Hg, respectively). Changes in the naproxen group were greater than those in the placebo group (differences of 3.11, 3.03, and 2.00 mm Hg, respectively). Systolic blood pressure increases ≥10 mm Hg from baseline to week 13 occurred in 13.3%, 15.0%, and 20.3% of patients receiving naproxcinod, placebo, and naproxen, respectively. Naproxcinod and naproxen had similar adverse event and general safety profiles. CONCLUSION The efficacy of naproxcinod for treating the signs and symptoms of hip osteoarthritis was statistically superior to that of placebo and similar to that of naproxen. Naproxcinod was well tolerated, with effects on systolic blood pressure similar to those of placebo.
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Sephton R, Hough E, Roberts SA, Oldham J. Evaluation of a primary care musculoskeletal clinical assessment service: a preliminary study. Physiotherapy 2010; 96:296-302. [DOI: 10.1016/j.physio.2010.03.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2009] [Accepted: 03/07/2010] [Indexed: 11/28/2022]
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A study on the efficacy of treatment with mud packs and baths with Sillene mineral water (Chianciano Spa Italy) in patients suffering from knee osteoarthritis. Rheumatol Int 2010; 31:1333-40. [DOI: 10.1007/s00296-010-1475-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2009] [Accepted: 03/27/2010] [Indexed: 10/19/2022]
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Osteoarthritis of the hip or knee: which coexisting disorders are disabling? Clin Rheumatol 2010; 29:739-47. [PMID: 20177725 PMCID: PMC2878451 DOI: 10.1007/s10067-010-1392-8] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Revised: 01/04/2010] [Accepted: 01/15/2010] [Indexed: 10/27/2022]
Abstract
Exercise therapy is generally recommended in osteoarthritis (OA) of the hip or knee. However, coexisting disorders may bring additional impairments, which may necessitate adaptations to exercise for OA of the hip or knee. For the purpose of developing an adapted protocol for exercise therapy in OA patients with coexisting disorders, information is needed on which specific coexisting disorders in OA are associated with activity limitations and pain. To describe the relationship between specific coexisting disorders, activity limitations, and pain in patients with OA of the hip or knee, a cross-sectional cohort study among 288 older adults (50-85 years of age) with OA of hip or knee was conducted. Subjects were recruited from three rehabilitation centers and two hospitals. Demographic data, clinical data, information about coexisting disorders (i.e., comorbidity and other disorders), activity limitations (WOMAC: physical functioning domain), and pain (visual analogue scale (VAS)) were collected by questionnaire. Statistical analysis included descriptive statistics and multivariate regression analysis. Coexisting disorders associated with activity limitations were chronic back pain or hernia, arthritis of the hand or feet, and other chronic rheumatic diseases (all musculoskeletal disorders); diabetes and chronic cystitis (non-musculoskeletal disorders); hearing impairments in a face-to-face conversation, vision impairments in long distances, and dizziness in combination with falling (all sensory impairments); and overweight and obesity. Coexistent disorders associated with pain were arthritis of the hand or feet, other chronic rheumatic diseases (musculoskeletal disorders), and diabetes (non-musculoskeletal disorder). Specific disorders coexisting next to OA and associated with additional activity limitations and pain were identified. These coexisting disorders need to be addressed in exercise therapy and rehabilitation for patients with OA of the hip or knee.
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Correlates of Pain Intensity in Men and Women With Hip and Knee Osteoarthritis. Results of a National Survey: The French ARTHRIX Study. Clin J Pain 2009; 25:767-72. [DOI: 10.1097/ajp.0b013e3181b43d4f] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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van Dijk GM, Veenhof C, Lankhorst GJ, Dekker J. Limitations in activities in patients with osteoarthritis of the hip or knee: The relationship with body functions, comorbidity and cognitive functioning. Disabil Rehabil 2009; 31:1685-91. [DOI: 10.1080/09638280902736809] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kirkness CS, Yu J, Asche CV. The Effect on Comorbidity and Pain in Patients with Osteoarthritis. J Pain Palliat Care Pharmacother 2009; 22:336-48. [DOI: 10.1080/15360280802536649] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Lübbeke A, Duc S, Garavaglia G, Finckh A, Hoffmeyer P. BMI and severity of clinical and radiographic signs of hip osteoarthritis. Obesity (Silver Spring) 2009; 17:1414-9. [PMID: 19197252 DOI: 10.1038/oby.2008.663] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Obesity might be involved in the pathogenesis of osteoarthritis (OA) not only via increased mechanical loading, but also via an inflammatory component possibly causing increased pain and functional disability. The study aim was to examine the relationship between BMI and clinical symptoms as well as radiographic severity of OA in patients scheduled for primary total hip arthroplasty (THA). We conducted a cross-sectional study of 855 patients scheduled for a first THA for primary OA at a single centre between November 2001 and December 2006. The primary outcome was clinical and radiographic severity of OA, which was evaluated in four BMI categories (18.5-24.9, 25-29.9, 30-34.9 and > or =35 kg/m(2)). We used the Harris Hip Score (HHS) and the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) to assess pain and function. The severity of radiographic hip joint damage was evaluated using the Kellgren-Lawrence classification. Multivariate analyses were performed to adjust for potential confounders. In patients scheduled for THA, increasing BMI was associated with significantly higher levels of pain and functional disability on both HHS (P for trend <0.001) and WOMAC (P for trend <0.001). However, the degree of radiographic joint damage remained similar across BMI categories. These findings emphasize the need to further investigate the potential pathogenic role of obesity and low-grade inflammation in OA and underscore the importance of obesity prevention to avoid early prosthetic replacement of the hip.
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Affiliation(s)
- Anne Lübbeke
- Division of Orthopaedic Surgery, Geneva University Hospitals, Geneva, Switzerland.
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Błaszczak E, Franek A, Taradaj J, Widuchowski J, Klimczak J. Assessment of the efficacy and safety of low frequency, low intensity magnetic fields in patients after knee endoprosthesis plasty. Part 1: In vitro safety. Bioelectromagnetics 2009; 30:159-62. [DOI: 10.1002/bem.20457] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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van Dijk GM, Veenhof C, Schellevis F, Hulsmans H, Bakker JP, Arwert H, Dekker JH, Lankhorst GJ, Dekker J. Comorbidity, limitations in activities and pain in patients with osteoarthritis of the hip or knee. BMC Musculoskelet Disord 2008; 9:95. [PMID: 18582362 PMCID: PMC2453124 DOI: 10.1186/1471-2474-9-95] [Citation(s) in RCA: 152] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2007] [Accepted: 06/26/2008] [Indexed: 12/02/2022] Open
Abstract
Background This study aims to contribute to the knowledge of the influence of comorbidity in OA. The objectives of the study were (i) to describe the prevalence of comorbidity and (ii) to describe the relationship between comorbidity (morbidity count, severity and the presence of specific diseases) and limitations in activities and pain in elderly patients with knee or hip OA using a comprehensive inventory of comorbidity. Methods A cross-sectional cohort study was conducted, in which 288 elderly patients with hip or knee osteoarthritis were included. Apart from demographic and clinical data, information about comorbidity, limitations in activities (WOMAC, SF-36 and timed walking test) and pain (VAS) was collected by questionnaires and tests. Statistical analyses included descriptive statistics, multivariate regression techniques, t-tests and one-way ANOVA. Results Almost all patients suffered from at least one comorbid disease, with cardiac diseases, diseases of eye, ear, nose, throat and larynx, other urogenital diseases and endocrine/metabolic diseases being most prevalent. Morbidity count and severity index were associated with more limitations in activities and with more pain. The presence of most of the moderate or severe diseases and obesity was associated with limitations in activities or with pain. Conclusion The results of this study emphasize the importance of comorbidity in the rehabilitation of elderly patients with osteoarthritis of the hip or knee. Clinical practitioners should be aware of the relationship of comorbidity with functional problems in OA patients.
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Affiliation(s)
- Gabriella M van Dijk
- NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands.
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Overweight and health problems of the lower extremities: osteoarthritis, pain and disability. Public Health Nutr 2008; 12:359-68. [PMID: 18426630 DOI: 10.1017/s1368980008002103] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AIM To examine the association between overweight and health problems of the lower extremities, i.e. osteoarthritis (OA), pain and disability. METHODS Cross-sectional data from the Dutch population-based Musculoskeletal Conditions & Consequences Cohort (DMC3), comprising a random sample from the Dutch population aged >25 years (n 3664), were analysed using multivariate logistic regression. Overweight was defined as BMI > or = 25.0 kg/m2, moderate overweight as 25.0 kg/m2 < or = BMI < 30.0 kg/m2 and obesity as BMI > or = 30.0 kg/m2. Health problems of the lower extremities were: (i) self-reported OA of the hip or knee as told by a doctor; (ii) presence of self-reported chronic pain (>3 months) of the lower extremities; and (iii) disabilities in mobility as measured by the Euroqol questionnaire (EQ-5D). RESULTS Moderate overweight was associated with self-reported OA of the hip or knee (OR = 1.7; 95 % CI 1.4, 2.1), chronic pain of the lower extremities at one or more location(s) (OR = 1.6; 95 % CI 1.3, 1.9) and disability in mobility (OR = 1.7; 95 % CI 1.4, 2.0). For obesity these odds were higher: 2.8 (95 % CI 2.1, 3.7), 2.5 (95 % CI 1.9, 3.2) and 3.0 (95 % CI 2.3, 3.9), respectively. Also, among those with OA, moderate overweight and obesity were associated with disability in mobility. CONCLUSION There is a strong association between overweight/obesity and health problems of the lower extremities, i.e. OA, pain and disability. The increasing prevalence of overweight and obesity worldwide urges for public health action not only for diabetes and heart disease, but also OA.
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Lübbeke A, Moons KGM, Garavaglia G, Hoffmeyer P. Outcomes of obese and nonobese patients undergoing revision total hip arthroplasty. ACTA ACUST UNITED AC 2008; 59:738-45. [DOI: 10.1002/art.23562] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Vasconcelos KSDS, Dias JMD, Dias RC. Impacto do grau de obesidade nos sintomas e na capacidade funcional de mulheres com osteoartrite de joelhos. FISIOTERAPIA E PESQUISA 2008. [DOI: 10.1590/s1809-29502008000200003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
As mulheres apresentam risco aumentado para a osteoartrite (OA) de joelhos e obesidade. Associadas, essas doenças podem gerar dor e prejuízos funcionais, principalmente em atividades de locomoção. Este estudo visou comparar o impacto do grau de obesidade nos sintomas e capacidade funcional de mulheres com OA de joelhos. Foram selecionadas 13 mulheres obesas (com índice de massa corporal - IMC>30 kg/m²) e 15 com obesidade mórbida (IMC>40 kg/m²), todas com OA bilateral de joelhos. Os sintomas de dor, rigidez e dificuldades funcionais foram avaliados pelo questionário The Western Ontario and McMaster Osteoarthritis Index (Womac). A capacidade funcional foi verificada por quatro testes de velocidade: marcha usual, marcha rápida, subir e descer escadas. Os dois grupos apresentaram um impacto moderado da obesidade na OA de joelhos, sem diferença quanto aos sintomas. As obesas se saíram melhor do que as obesas mórbidas nos testes de marcha usual e subir escadas, mas não nas atividades de marcha rápida e descer escadas, mais complexas e estressantes para a articulação do joelho. Conclui-se que o grau de obesidade não teve impacto nos sintomas de dor, rigidez e dificuldades funcionais associadas à OA de joelhos entre mulheres obesas e obesas mórbidas. E, em dois testes de capacidade funcional, as obesas dos dois grupos tiveram desempenho semelhante, sugerindo que outros fatores podem influenciar o desempenho funcional de obesas com OA de joelhos.
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Stamm T, Mathis M, Aletaha D, Kloppenburg M, Machold K, Smolen J. Mapping hand functioning in hand osteoarthritis: comparing self-report instruments with a comprehensive hand function test. ACTA ACUST UNITED AC 2007; 57:1230-7. [PMID: 17907208 DOI: 10.1002/art.22989] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To determine which self-report instruments best explain hand functioning measured by a generic comprehensive hand function test. METHODS Six questionnaires currently used in hand osteoarthritis (OA), namely, the Arthritis Impact Measurement Scales 2 Short Form (AIMS2-SF), the Australian/Canadian Osteoarthritis Hand Index (AUSCAN), the Cochin scale, the Functional Index of Hand OA (FIHOA), the Health Assessment Questionnaire (HAQ), and the Score for Assessment and Quantification of Chronic Rheumatoid Affections of the Hands (SACRAH), were administered once in 100 patients with hand OA together with the Jebsen-Taylor Hand Function Test (JTHFT). In addition, 3 other hand function tests with short administration time were used: the Moberg Picking-Up Test (MPUT), the Button Test (BT), and grip strength. The Short Form 36 was used to describe health status. The relationship between the instruments and the JTHFT was determined by correlation analyses. RESULTS AIMS2-SF total scores had the highest raw correlation coefficient to the JTHFT, followed by AIMS2-SF upper body limitation subscale, SACRAH stiffness subscale, and SACRAH total score. If controlled for age, the HAQ had the highest correlation coefficient. Of the 3 short hand function tests, the MPUT showed the highest raw correlation coefficient to the JTHFT; if controlled for age, the BT had the highest correlation coefficient. CONCLUSION To comprehensively assess hand functioning in patients with hand OA, we recommend using both a self-report instrument used more generally in various arthritides and a self-report instrument specifically developed for hand OA. If a short test is preferred, we recommend using the MPUT or BT.
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Marks R. Obesity profiles with knee osteoarthritis: correlation with pain, disability, disease progression. Obesity (Silver Spring) 2007; 15:1867-74. [PMID: 17636106 DOI: 10.1038/oby.2007.221] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To identify the prevalence of overweight among community-dwelling adults diagnosed as having knee osteoarthritis (OA) and the relationship between the weight status of these individuals, selected disease-related outcomes, and disease progression. RESEARCH METHODS AND PROCEDURES The BMIs of 82 women and 18 men with unilateral or bilateral knee OA were examined on a single occasion along with data on physical comorbidities, pain, and function and subjected to correlation analyses. BMIs from two additional samples, one that included 16 women with and without knee OA and one that included 24 women and 6 men with knee joint OA that required surgery for the subsequent onset of hip OA, were also assessed. RESULTS At least 80% of all present cohorts were overweight or obese. Those with higher BMIs reported more pain than those with lower BMIs (p<0.05) and pain was related to perceived physical exertion (p<0.05). Body mass indices were not significantly correlated with generic gait measures, but an inverse trend toward the time spent in the gait cycle (r=-0.63; p=0.097) that may impact the disease process was identified. Those with comorbidities had the same body mass, on average, as those with no comorbidities, and those with bilateral disease were heavier than those with unilateral disease. DISCUSSION A high body mass is present in most adults with knee OA. Moreover, being overweight may affect knee joint impact rates and pain incrementally. Having high body weights may heighten the risk for bilateral knee joint, as well as hip joint, OA.
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Affiliation(s)
- Ray Marks
- Department of Health and Behavior Studies, Columbia University, Teachers College, Box 114, 525W 120th Street, New York, NY 10027, USA.
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Sarzi-Puttini P, Cimmino MA, Scarpa R, Caporali R, Parazzini F, Zaninelli A, Atzeni F, Marcolongo R. Do physicians treat symptomatic osteoarthritis patients properly? Results of the AMICA experience. Semin Arthritis Rheum 2005; 35:38-42. [PMID: 16084232 DOI: 10.1016/j.semarthrit.2005.02.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The main objective of the AMICA project was to photograph the Italian scenario of osteoarthritis (OA) and its treatment in general and specialty practice. The study was designed to evaluate their prescription modalities to determine whether they matched the recently proposed treatment guidelines for OA (ACR 2000; EULAR 2000; APS 2002). METHODS The study involved 2764 general practitioners (GPs) and 316 specialists who enrolled a total of 25,589 patients with OA of the hand, knee, and hip. RESULTS Pharmacological treatment alone was prescribed to 55% of the patients seen by GPs, 25% of those seen by rheumatologists, 8% of those seen by orthopedic surgeons, and 17% of those seen by physical medicine specialists (GPs versus specialists, P < 0.001). Specialists often prescribed a combined pharmacological and nonpharmacological approach (rheumatologists 51%, orthopedic surgeons 66%, physical medicine specialists 76%). Concomitant comorbidities and their treatment do not seem to influence OA prescription modalities except for peptic ulcer and anticoagulant therapy. The presence of peptic ulcer was associated with a reduction in NSAID prescriptions (OR 0.61, CI 0.53 to 0.69) and more frequent use of Coxibs (OR 1.15, CI 1.03 to 1.28) and simple analgesics (OR 1.42; CI 1.26 to 1.61), as well as physical therapy. NSAIDs and Coxibs also were less frequently prescribed if patients were receiving anticoagulant therapy (NSAIDs OR 0.86, CI 0.70 to 1.06; Coxibs: OR 0.77; CI 0.64 to 0.93). Gastroprotective therapy was more frequently used in patients treated with NSAIDs, Coxibs, and analgesics. There was no significant difference in therapies prescribed for patients with hypertension or cardiac disease (myocardial infarction and/or angina pectoris). CONCLUSIONS The published guidelines appear to be properly used by most of the physicians in terms of the pharmacological approach; however, the increased use of Coxibs has not reduced the amount of prescribed gastroprotection. No specific precautions were observed in the treatment of patients with hypertension or cardiac problems. Nonpharmacological treatments are mainly used in conjunction with medications and did not take into account the findings of evidence-based medicine. Continuing education of GPs and specialists caring for OA patients is essential.
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