Allergic Asthma and Eczema Linked to Risk of Osteoarthritis, Study Finds

Patients with atopic diseases, such as allergic asthma and eczema, may be at increased risk of osteoarthritis (OA), according to one study.

“Patients with atopic disease have an increased risk of developing OA compared with the general population,” wrote the researchers. “The association between atopic disease and OA is supported by recent observations that mast cells and type II cytokines may play important roles in the pathogenesis broadly, not just in patients with atopic disease.”

The results of this retrospective cohort study were published in BMJ Open Epidemiological Science.

Osteoarthritis is the most common form of arthritis and is characterized as a painful often disabling joint condition. Despite its prevalence, there is no effective cure for osteoarthritis, with treatments tailored for symptom and pain management.

Using claims data from January 2003 to June 2019, and electronic health record data from January 2010 to December 2020, the researchers aimed to determine the incidence of OA in adult patients with and without atopic diseases.

The study included at total of 117,346 individuals with allergic asthma or eczema. These individuals had an average age of 52 years and were mostly women (60%). The study also included a total of 1,247,196 individuals without atopic diseases. These individuals had an average age of 50 years, and 48% were women.

Patients with asthma or eczema (n = 109,899) were propensity score matched with patients without asthma or eczema (n = 109,899). The mean age in both cohorts was 52 years, 59% were female, a mean Charlson Comorbidity Score of 1.6, a mean number of outpatient visits per year of 7, and a mean follow-up time of 8 years.

As a result, the incidence of OA was higher among patients with asthma or eczema (26.9 per 1000 person-years) compared with non-exposed patients (19.1 per 1000 person-years), with an adjusted odds ratio (AOR, 1.58; 95% CI (1.55-1.62) for developing OA.

In patients with both asthma and eczema, this incidence was even higher (AOR, 2.15; 95% CI, 1.93-2.39) compared with non-exposed patients and patients with chronic obstructive pulmonary disease (COPD) (AOR, 1.83; 95% CI, 1.73-1.95).

Lastly, when replicating results in an independent dataset, the researchers found the incidence of OA was weaker when including body mass index (BMI) data (AOR, 1.42, 95% CI, 1.36-1.48).

The researchers acknowledge that there were limitations to their study, including lack of available data on the severity of asthma and eczema, as well as the severity of osteoarthritis.

Despite limitations, the researchers believe that this study shows an increased incidence of OA in patients with atopic diseases, such as asthma and eczema. The researchers also believe that future studies should evaluate possible interventions that target allergic pathways in prevention and treatment of patients with osteoarthritis.

“Our findings provide further support for the concept that allergic pathways may contribute to the development of OA,” concluded the researchers. “If this is indeed true, non-atopic patients may also benefit from the use of treatments that inhibit mast cells and allergic cytokines to treat or prevent OA.”

Reference

Baker M, Sheth K, Lu R, et al. Increased risk of osteoarthritis in patients with atopic disease. BMJ Open Epidemiological Science. 2023;27(3). doi.org/10.1136/ard-2022-223640