Rheum Round-up: Comorbidities in OA, Racial Disparities in TKA Outcomes, and more

Here are the top stories recently covered by DocWire News in the rheumatology section. In this edition, read about the increased risk for comorbidities in osteoarthritis patients, outcomes for black knee arthroplasty patients, exercise in women with osteoporosis after vertebral fracture, and more.

Patients with osteoarthritis (OA) are at a greater risk of suffering from comorbidities compared to the general population, a study suggests. A total of 42 studies from 16 countries were included for review. The pooled prevalence ratio (PR) for any comorbidity was 1.21 (95% CI, 1.02 to 1.45); the PR increased with the number of comorbidities. For one comorbidity, the PR was 0.73 (95% CI, 0.43 to 1.25); for two, the PR was 1.58 (95% CI, 1.03 to 2.42); and for three or more comorbidities, the PR was 1.94 (95% CI, 1.45 to 2.59).

A recent study evaluated time trends and risk factors for 30-day adverse events (AEs) among black patients who undergo total knee arthroplasty (TKA). The analysis included 19,496 black TKA patients treated during the study period, during which time comorbidity profiles improved, length of stay decreased, and the rate of AEs was reduced. Risk factors associated with AEs were male gender, tobacco smoking, American Society of Anesthesiologists score >2, dependent functional status, congestive heart failure, chronic obstructive pulmonary disease, metastatic cancer, dyspnea, chronic kidney disease, bilateral TKA, and operative time >100 minutes.

A study evaluated the effects of exercise on women with osteoporosis and vertebral fracture and observed improvements in muscle strength, balance, and mobility, and less of a fear of falling. This was a follow-up study that took place three months after an intervention as part of a randomized, controlled trial that randomized 149 women aged 65 years or older with osteoporosis and vertebral fracture to either an exercise or control group. At the three-month post-intervention follow-up, the mean between-group difference in habitual walking speed was not statistically significant. However, physical fitness outcomes differed and significantly favored the exercise group, including balance, arm curl, leg strength, and mobility. The exercise group also had a significantly lower fear of falling.

Ibuprofen may help manage pain in pediatric fracture cases without delaying healing, according to a study. Final analysis included 95 patients (97 fractures) who completed six months of follow-up: 49 patients (50 fractures) in the nonsteroidal anti-inflammatory drug (NSAID) group and 46 patients (47 fractures) in the control group. None of the patients in either group achieved healing at two weeks. At six weeks, a greater proportion of patients in the NSAID group achieved healing than the control group. At 10- to 12-week follow-up, all fractures in the ibuprofen group and 98% in the control group were healed; at six months, all fractures were completely healed. The mean time to healing in the ibuprofen group was 31 days and in the control group was 40 days. Breakthrough oxycodone was used a mean 1.9 days in the NSAID group and 2.4 days in the control group.

A study ascertained the effect of joint and skin symptoms on psoriatic arthritis (PsA) patients and found that they contribute significantly to poorer clinical outcomes, health-related quality of life, and work productivity, compared to patients with only joint symptoms. Data from 2,703 patients were included. About two-thirds of patients (64.5%) had joint and skin involvement. The mean tender joint count was higher for joint and skin involvement patients than joint only patients (5.2 vs. 2.0), as was the mean swollen joint count (4.8 vs. 1.5). Twelve-month flare history was significantly more prevalent among active joint and skin symptoms patients versus joint only patients (34.9% vs. 23.2%; P<0.001). More patients prioritized symptom burden pertaining to joints than skin (61.6% vs. 38.4%). About two in 10 patients (41.4%) experienced anxiety depression; of these patients, about two-thirds (62.4%) attributed it to both skin and joint symptoms.