Asthma patients or those with atopic dermatitis are at a higher probability of developing osteoarthritis (OA), suggests a study recently published in the Annals of Rheumatic Disease.¹

Matthew C Baker from the Division of Immunology and Rheumatology, Department of Medicine, Stanford University in California, USA and coauthors conducted this retrospective study to determine the occurrence of of new-onset osteoarthritis (OA) in patients with atopic diseases compared to those without atopic disease. For this, they utilised data of 117,346 patients with asthma and atopic dermatitis (mean age 52 years; 60% female) from the Optum Clinformatics Data Mart between January 2003 and June 2019 and electronic health records from the Stanford Research Repository (STARR) between January 2010 and December 2020. From the Optum claims database, 1,247,196 persons, mean age 50 years, without asthma or atopic dermatitis were also identified as controls. Patients with diagnosed OA or those with a history of inflammatory arthritis were not included in the study.

After adjusting for age, sex, race/ethnicity, comorbidities, level of education, OPD visit and duration of follow-up, patients with asthma or atopic dermatitis were more likely to develop new-onset osteoarthritis (26.9 per 1000 person-years) vs those without asthma or atopic dermatitis (19.1 per 1000 person-years) with an adjusted odds ratio (aOR) of 1.58 in the Optum cohort. The risk was doubled in patients with coexisting asthma and atopic dermatitis with aOR of 2.15 and in those who had asthma in comparison with those with COPD (aOR 1.83). These results were replicated in the STARR cohort, which also adjusted for body mass index (BMI); the risk for osteoarthritis was also found to be increased in patients with asthma or atopic dermatitis with an aOR of 1.42.

The authors hypothesise that allergic pathways through the mast cells and type II cytokines may be the key to development of OA in these patients. They further suggest that “future interventional studies could consider targeting these pathways for the treatment of OA”.

Reference

1. Baker MC, et al. Increased risk of osteoarthritis in patients with atopic disease. Ann Rheum Dis. 2023 Mar 27;ard-2022-223640. doi: 10.1136/ard-2022-223640.