Division of Immunology and Rheumatology, Department of Medicine, Stanford University, Stanford, California, USA
Division of Immunology and Rheumatology, Department of Medicine, Stanford University, Stanford, California, USA.
Ann Rheum Dis. 2023 Jun;82(6):866-872. doi: 10.1136/ard-2022-223640. Epub 2023 Mar 27.
To determine the incidence of osteoarthrits (OA) in patients with atopic disease compared with matched non-exposed patients.
We conducted a retrospective cohort study with propensity score matching using claims data from Optum's de-identified Clinformatics Data Mart (CDM) (January 2003 to June 2019) and electronic health record data from the Stanford Research Repository (STARR) (January 2010 to December 2020). We included adult patients without pre-existing OA or inflammatory arthritis who were exposed to atopic disease or who were non-exposed. The primary outcome was the development of incident OA.
In Optum CDM, we identified 117 346 exposed patients with asthma or atopic dermatitis (mean age 52 years; 60% female) and 1 247 196 non-exposed patients (mean age 50 years; 48% female). After propensity score matching (n=1 09 899 per group), OA incidence was higher in patients with asthma or atopic dermatitis (26.9 per 1000 person-years) compared with non-exposed patients (19.1 per 1000 person-years), with an adjusted odds ratio (aOR) of 1.58 (95% CI 1.55 to 1.62) for developing OA. This effect was even more pronounced in patients with both asthma and atopic dermatitis compared with non-exposed patients (aOR=2.15; 95% CI 1.93 to 2.39) and in patients with asthma compared with patients with chronic obstructive pulmonary disease (aOR=1.83; 95% CI 1.73 to 1.95). We replicated our results in an independent dataset (STARR), which provided the added richness of body mass index data. The aOR of developing OA in patients with asthma or atopic dermatitis versus non-exposed patients in STARR was 1.42 (95% CI 1.36 to 1.48).
This study demonstrates an increased incidence of OA in patients with atopic disease. Future interventional studies may consider targeting allergic pathways for the prevention or treatment of OA.
确定特应性疾病患者发生骨关节炎（OA）的发病率与匹配的非暴露患者相比。
我们进行了一项回顾性队列研究，使用 Optum 的去识别 Clinformatics Data Mart（CDM）（2003 年 1 月至 2019 年 6 月）的索赔数据和斯坦福研究存储库（STARR）（2010 年 1 月至 2020 年 12 月）的电子健康记录数据进行倾向评分匹配。我们纳入了无预先存在的 OA 或炎症性关节炎且暴露于特应性疾病或未暴露于特应性疾病的成年患者。主要结局是发生新的 OA。
在 Optum CDM 中，我们确定了 117346 例患有哮喘或特应性皮炎的暴露患者（平均年龄 52 岁；60%为女性）和 1247196 例未暴露患者（平均年龄 50 岁；48%为女性）。经过倾向评分匹配（每组 109899 例）后，与未暴露患者（19.1/1000 人年）相比，哮喘或特应性皮炎患者的 OA 发病率更高（26.9/1000 人年），校正优势比（aOR）为 1.58（95%CI 1.55 至 1.62）。与未暴露患者相比，同时患有哮喘和特应性皮炎的患者的这种效果更为明显（aOR=2.15；95%CI 1.93 至 2.39），与患有慢性阻塞性肺疾病的患者相比（aOR=1.83；95%CI 1.73 至 1.95）。我们在独立数据集（STARR）中复制了我们的结果，该数据集提供了体重指数数据的额外丰富性。在 STARR 中，哮喘或特应性皮炎患者发生 OA 的 aOR 与未暴露患者相比为 1.42（95%CI 1.36 至 1.48）。
这项研究表明特应性疾病患者的 OA 发病率增加。未来的干预性研究可能会考虑针对过敏途径预防或治疗 OA。
