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Review
. 2020 Dec 25:12:1759720X20981219.
doi: 10.1177/1759720X20981219. eCollection 2020.

Osteoarthritis, mobility-related comorbidities and mortality: an overview of meta-analyses

Gustavo Constantino de Campos  1 , Raman Mundi  2 , Craig Whittington  3 , Marie-Josée Toutounji  4 , Wilson Ngai  4 , Brendan Sheehan  5
Affiliations
Review

Osteoarthritis, mobility-related comorbidities and mortality: an overview of meta-analyses

Gustavo Constantino de Campos et al. Ther Adv Musculoskelet Dis. .

Abstract

Aims: The objective of this review was to examine the relationship between osteoarthritis (OA) and mobility-related comorbidities, specifically diabetes mellitus (DM) and cardiovascular disease (CVD). It also investigated the relationship between OA and mortality.

Methods: An overview of meta-analyses was conducted by performing two targeted searches from inception to June 2020. The association between OA and (i) DM or CVD (via PubMed and Embase); and (ii) mortality (via PubMed) was investigated. Meta-analyses were selected if they included studies that examined adults with OA at any site and reported associations between OA and DM, CVD, or mortality. Evidence was synthesized qualitatively.

Results: Six meta-analyses met inclusion criteria. One meta-analysis of 20 studies demonstrated a statistically significant association between OA and DM, with pooled odds ratio of 1.41 (95% confidence interval: 1.21, 1.65; n = 1,040,175 patients). One meta-analysis of 15 studies demonstrated significantly increased risk of CVD among OA patients, with a pooled risk ratio of 1.24 (1.12, 1.37, n = 358,944 patients). Stratified by type of CVD, OA was shown to be associated with increased heart failure (HF) and ischemic heart disease (IHD) and reduced transient ischemic attack (TIA). There was no association reported for stroke or myocardial infarction (MI). Three meta-analyses did not find a significant association between OA (any site) and all-cause mortality. However, OA was found to be significantly associated with cardiovascular-related death across two meta-analyses.

Conclusion: The identified meta-analyses reported significantly increased risk of both DM and CVD (particularly, HF and IHD) among OA patients. It was not possible to confirm consistent directional or causal relationships. OA was found to be associated with increased mortality, but mostly in relation to CVD-related mortality, suggesting that further study is warranted in this area.

Keywords: cardiovascular diseases; comorbidity; diabetes mellitus; osteoarthritis; review.

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Conflict of interest statement

Conflict of interest statement: Gustavo Campos reports speaker/honoraria and consulting for Sanofi. Raman Mundi reports personal fees received for participation in advisory board meetings from Sanofi, Pendopharm, and KCI. Craig Whittington is currently employed by Sanofi, and is a former employee of Doctor Evidence, LLC, who were contracted by Sanofi to conduct this study. Marie-Josée Toutounji and Wilson Ngai are currently employed by Sanofi. Brendan Sheehan reports speaker/honoraria and consulting for Sanofi. All authors met the ICMJE authorship criteria.

Figures

Figure 1.
Figure 1.
PRISMA flow diagram. PRISMA, preferred reporting items for systematic reviews and meta-analyses.
Figure 2.
Figure 2.
Association between OA and DM or CVD across the included publications (based on separate meta-analyses). *Calculated by adding sample sizes from the three studies– included in Louati et al., which contributed to the association measure for risk of diabetes in hand OA. CI, confidence interval; CVD, cardiovascular disease; DM, diabetes mellitus; HF, heart failure; IHD, ischaemic heart disease; MI, myocardial infarction; OA, osteoarthritis; TIA, transient ischaemic attack.
Figure 3.
Figure 3.
Association between OA and mortality across the included publications (based on separate meta-analyses). CI, confidence interval; CV, cardiovascular; NR, not reported; OA, osteoarthritis; ROA, radiographic osteoarthritis; SOA, symptomatic osteoarthritis; SROA, symptomatic radiographic osteoarthritis; US, United States.
See this image and copyright information in PMC

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