Comorbidity in Incident Osteoarthritis Cases and Matched Controls Using Electronic Health Record Data
18 Pages Posted: 18 Jun 2022
Abstract
Objectives: Comorbidities are commonly seen in patients with osteoarthritis (OA). The aim was to determine the odds ratio of exposure to multiple comorbidities in adults with newly diagnosed OA, compared to matched controls without OA.
Methods: A case-control study was performed using data from the Integrated Primary Care Information database, an electronic health record database comprising 2.5 million patients from Dutch general practices. OA cases were defined as adults diagnosed with incident OA between January 1st, 2006 and December 31st, 2019. Diagnosis was based on one of the following ICPC codes: L89 (hip OA), L90 (knee OA) and L91 (other/peripheral OA). The first registration of an OA code within the study period was defined as the index date. Each case was matched with 1-4 controls according to age, general practice and sex, using incidence density sampling. 58 comorbidities were selected and analyzed individually. Prevalence of each comorbidity at the index date was compared between cases and controls and presented as odds ratios.
Results: We identified 80,099 incident OA patients of whom 79,937 (99.8%) were successfully matched with 318,206 controls. Patients with incident OA had higher odds for 42 of the 58 studied comorbidities. Other musculoskeletal conditions and obesity displayed the largest associations, but also new insights in comorbidity patterns were found.
Conclusion: This study confirms known associations whilst unravelling new comorbidity patterns among OA patients. Understanding which comorbidities are more common in OA, is the first step in contributing to reduce the large burden of OA.
Note:
Declaration of Interests: JvdL, MdR and MdW work for a research institute who received unconditional research grants from Yamanouchi, Pfizer-Boehringer Ingelheim, GSK, Amgen, UCB, Novartis, Astra-Zeneca, Chiesi, Janssen Research and Development. In addition, the research institute received research grants from The Netherlands Organization for Health Research and Development, the European Commission Framework Programs, and several charitable foundations. SBZ received grants from The Netherlands Organization for Health Research and Development, CZ, European Union, Dutch Arthritis Association, and consulting fees from Pfizer. ME declares serving as an advisory Panel Board Member for Pfizer (Nov 2019, Tanezumab). WZ declares serving as an advisory board for Ely Lilly (Ixekizumad, 2020) and Regeneron (Fasinomab, 2020). DPA’s research group has received grant support from Les Laboratoires Servier, Amgen, Astellas, AstraZeneca, Chesi-Taylor, Johnson and Johnson and UCD. Furthermore they received advisory, speaker/ Consultancy fees from Amgen, Astellas, AstraZeneca, Chesi-Taylor, Johnson and Johnson and UCD, and advisory board membership services from Amgen. Finally, Janssen, on behalf of IMI-funded EHDEN and EMIF consortiums, and Synapse Management Partners have supported training programs organized by DPA's department and open for external participants. The other authors report no potentially competing interests.
Ethics Approval Statement: The scientific and ethical advisory board of the IPCI project approved the study (registration number 11/2019).
Keywords: Osteoarthritis (OA), Comorbidity, Case-control study, Primary care, Electronic health record (EHR)
Suggested Citation: Suggested Citation