Exploratory analysis of osteoarthritis progression among medication users: data from the Osteoarthritis Initiative
Department of Quantitative Health Sciences
Musculoskeletal Diseases | Rheumatology
BACKGROUND: We conducted an exploratory analysis of osteoarthritis progression among medication users in the Osteoarthritis Initiative to identify interventions or pathways that may be associated with disease modification and therefore of interest for future clinical trials.
METHODS: We used participants from the Osteoarthritis Initiative with annual medication inventory data between the baseline and 36-month follow-up visit (n = 2938). Consistent medication users were defined for each medication classification as a participant reporting at all four annual visits that they were regularly using an oral prescription medication at the time of the visit. The exploratory analysis focused on medication classes with 40 or more users. The primary outcome measures were medial tibiofemoral joint space width change and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) knee pain score change (12-36-month visits). Within each knee, we explored eight comparisons between users and matched or unmatched nonusers (defined two ways). An effect size of each comparison was calculated. Medication classes had potential signals if (a) both knees had less progression among users compared with nonusers, or (b) there was less progression based on structure and symptoms in one knee.
RESULTS: We screened 28 medication classes. Six medication classes had signals for fewer structural changes and better knee pain changes: alpha-adrenergic blockers, antilipemic (excluding statins and fibric acid), anticoagulants, selective serotonin reuptake inhibitors, antihistamines, and antineoplastic agents. Four medication classes had signals for structural changes alone: anti-estrogen (median effect size = 0.28; range = -0.41-0.64), angiotensin-converting enzyme inhibitors (median effect size = 0.13; range = -0.08-0.28), beta-adrenergic blockers (median effect size = 0.09; range = 0.01-0.30), and thyroid agents (median effect size = 0.04; range = -0.05-0.14). Thiazide diuretics had evidence for symptom modification (median effect size = -0.12; range = -0.24-0.04).
CONCLUSIONS: Users of neurovascular, antilipemic, or hormonal interventions may have less disease progression compared with nonusers.
knee, pain, radiographs
DOI of Published Version
Ther Adv Musculoskelet Dis. 2016 Dec;8(6):207-219. Epub 2016 Aug 24. Link to article on publisher's site
Therapeutic advances in musculoskeletal disease
Driban JB, Lo GH, Eaton CB, Lapane KL, Nevitt M, Harvey WF, McCulloch CE, McAlindon TE. (2016). Exploratory analysis of osteoarthritis progression among medication users: data from the Osteoarthritis Initiative. Open Access Articles. https://doi.org/10.1177/1759720X16664323. Retrieved from https://escholarship.umassmed.edu/oapubs/3032