Knee osteoarthritis and time-to all-cause mortality in six community based cohorts: an international meta-analysis of individual participant-level data
Knee osteoarthritis and time-to all-cause mortality in six community based cohorts: an international meta-analysis of individual participant-level data
Background: Osteoarthritis (OA) is a chronic joint disease, with increasing global burden of disability and healthcare utilisation. Recent meta-analyses have shown a range of effects of OA on mortality, reflecting different OA definitions and study methods. We seek to overcome limitations introduced when using aggregate results by gathering individual participant-level data (IPD) from international observational studies and standardising methods to determine the association of knee OA with mortality in the general population. Methods: Seven community-based cohorts were identified containing knee OA-related pain, radiographs, and time-to-mortality, six of which were available for analysis. A two-stage IPD meta-analysis framework was applied: (1) Cox proportional hazard models assessed time-to-mortality of participants with radiographic OA (ROA), OA-related pain (POA), and a combination of pain and ROA (PROA) against pain and ROA-free participants; (2) hazard ratios (HR) were then pooled using the Hartung–Knapp modification for random-effects meta-analysis. Findings: 10,723 participants in six cohorts from four countries were included in the analyses. Multivariable models (adjusting for age, sex, race, BMI, smoking, alcohol consumption, cardiovascular disease, and diabetes) showed a pooled HR, compared to pain and ROA-free participants, of 1.03 (0.83, 1.28) for ROA, 1.35 (1.12, 1.63) for POA, and 1.37 (1.22, 1.54) for PROA. Discussion: Participants with POA or PROA had a 35–37% increased association with reduced time-to-mortality, independent of confounders. ROA showed no association with mortality, suggesting that OA-related knee pain may be driving the association with time-to-mortality. Funding: Versus Arthritis Centre for Sport, Exercise and Osteoarthritis and Osteoarthritis Research Society International.
Knee, Meta-analysis, Mortality, Osteoarthritis
529-545
Leyland, Kirsten M.
1fa50316-86aa-43f9-b37e-d9d0111de19c
Gates, Lucy
bc67b8b8-110b-4358-8e1b-6f1d345bd503
Sanchez-Santos, Maria T.
3287c8bd-6e98-45a5-9198-431de4e5f9c8
Nevitt, Michael
aa7b464e-6ff2-41ce-894f-15846a6699cd
Felson, David
b85fcc74-452e-4059-a3b7-2fd0d68070f3
Jones, Graeme
f26c7d03-cd84-40c8-ae3a-286e861a5a29
Jordan, Joanne M
b1172d85-7887-454f-83fb-445f5f48c0a6
Judge, Andrew
8fed3977-493a-4290-b6c7-ce1a558698b5
Alhambra, Dani Prieto
542d46be-65f9-4ae3-a45f-c1ceada3adff
Yoshimura, Noriko
00436389-57b3-444c-b69d-0dc934d8e0d5
Newton, Julia
7dee32ca-3f29-4836-9d4c-c8b279b89d22
Callahan, Leigh F.
9a6582f6-a249-41df-9d45-f6739337c42f
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Batt, Mark
c5c9d1c7-e49e-4133-8e88-495d278737c1
Lin, Jianhao
0f5f3f46-268d-45ef-a22e-348b6723979c
Liu, Qiang
a0b56d66-a946-44e9-9dc2-2a9d6b476ae2
Cleveland, Rebecca
1c74d8a2-c6ba-4c7f-897e-d90383dde5fd
Collins, Gary
f295b909-e003-4542-8e43-281036df3060
Arden, Nigel K.
23af958d-835c-4d79-be54-4bbe4c68077f
March 2021
Leyland, Kirsten M.
1fa50316-86aa-43f9-b37e-d9d0111de19c
Gates, Lucy
bc67b8b8-110b-4358-8e1b-6f1d345bd503
Sanchez-Santos, Maria T.
3287c8bd-6e98-45a5-9198-431de4e5f9c8
Nevitt, Michael
aa7b464e-6ff2-41ce-894f-15846a6699cd
Felson, David
b85fcc74-452e-4059-a3b7-2fd0d68070f3
Jones, Graeme
f26c7d03-cd84-40c8-ae3a-286e861a5a29
Jordan, Joanne M
b1172d85-7887-454f-83fb-445f5f48c0a6
Judge, Andrew
8fed3977-493a-4290-b6c7-ce1a558698b5
Alhambra, Dani Prieto
542d46be-65f9-4ae3-a45f-c1ceada3adff
Yoshimura, Noriko
00436389-57b3-444c-b69d-0dc934d8e0d5
Newton, Julia
7dee32ca-3f29-4836-9d4c-c8b279b89d22
Callahan, Leigh F.
9a6582f6-a249-41df-9d45-f6739337c42f
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Batt, Mark
c5c9d1c7-e49e-4133-8e88-495d278737c1
Lin, Jianhao
0f5f3f46-268d-45ef-a22e-348b6723979c
Liu, Qiang
a0b56d66-a946-44e9-9dc2-2a9d6b476ae2
Cleveland, Rebecca
1c74d8a2-c6ba-4c7f-897e-d90383dde5fd
Collins, Gary
f295b909-e003-4542-8e43-281036df3060
Arden, Nigel K.
23af958d-835c-4d79-be54-4bbe4c68077f
Leyland, Kirsten M., Gates, Lucy, Sanchez-Santos, Maria T., Nevitt, Michael, Felson, David, Jones, Graeme, Jordan, Joanne M, Judge, Andrew, Alhambra, Dani Prieto, Yoshimura, Noriko, Newton, Julia, Callahan, Leigh F., Cooper, Cyrus, Batt, Mark, Lin, Jianhao, Liu, Qiang, Cleveland, Rebecca, Collins, Gary and Arden, Nigel K.
(2021)
Knee osteoarthritis and time-to all-cause mortality in six community based cohorts: an international meta-analysis of individual participant-level data.
Aging Clinical and Experimental Research, 33 (3), .
(doi:10.1007/s40520-020-01762-2).
Abstract
Background: Osteoarthritis (OA) is a chronic joint disease, with increasing global burden of disability and healthcare utilisation. Recent meta-analyses have shown a range of effects of OA on mortality, reflecting different OA definitions and study methods. We seek to overcome limitations introduced when using aggregate results by gathering individual participant-level data (IPD) from international observational studies and standardising methods to determine the association of knee OA with mortality in the general population. Methods: Seven community-based cohorts were identified containing knee OA-related pain, radiographs, and time-to-mortality, six of which were available for analysis. A two-stage IPD meta-analysis framework was applied: (1) Cox proportional hazard models assessed time-to-mortality of participants with radiographic OA (ROA), OA-related pain (POA), and a combination of pain and ROA (PROA) against pain and ROA-free participants; (2) hazard ratios (HR) were then pooled using the Hartung–Knapp modification for random-effects meta-analysis. Findings: 10,723 participants in six cohorts from four countries were included in the analyses. Multivariable models (adjusting for age, sex, race, BMI, smoking, alcohol consumption, cardiovascular disease, and diabetes) showed a pooled HR, compared to pain and ROA-free participants, of 1.03 (0.83, 1.28) for ROA, 1.35 (1.12, 1.63) for POA, and 1.37 (1.22, 1.54) for PROA. Discussion: Participants with POA or PROA had a 35–37% increased association with reduced time-to-mortality, independent of confounders. ROA showed no association with mortality, suggesting that OA-related knee pain may be driving the association with time-to-mortality. Funding: Versus Arthritis Centre for Sport, Exercise and Osteoarthritis and Osteoarthritis Research Society International.
Text
Knee osteoarthritis and time-to all-cause mortality in six community based cohorts
- Accepted Manuscript
More information
Accepted/In Press date: 26 November 2020
e-pub ahead of print date: 15 February 2021
Published date: March 2021
Additional Information:
Funding Information:
This study was funded by the Sport, Exercise and Osteoarthritis Centre: Versus Arthritis and the PCCOA, Osteoarthritis Research Society International. This study would not have been possible without the late Professor Doug Altman, who was instrumental in the study conception, design, and analysis. We are grateful to Sally Sheard for her help in acquiring and harmonising the data used in this manuscript. PCCOA (Pre-Competitive Consortium for Osteoarthritis) OARSI steering committee: Lyn March (lyn.march@sydney.edu.au); Gillian Hawker (g.hawker@utoronto.ca); Philip Conaghan (P.Conaghan@leeds.ac.uk); Virginia Byers Kraus (kraus004@duke.edu); Ali Guermazi (guermazi@bu.edu); David Hunter (David.Hunter@sydney.edu.au); Jeffrey N. Katz (jnkatz@bwh.harvard.edu); Tim McAlindon (tmcalindon@tuftsmedicalcenter.org); Tuhina Neogi (tneogi@bu.edu); Lee Simon (lssconsult@aol.com); Marita Cross (marita.cross@sydney.edu.au); Lauren King (laurenkarinaking@gmail.com).
Funding Information:
This study was funded by the Centre for Sport Exercise and Osteoarthritis Research Versus Arthritis (grant 21595).
Funding Information:
Dr Leyland reports grants from the Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, during the conduct of the study. Dr Gates is funded by the Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis. Professor Arden reports grants from the Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, grants from Merck, and personal fees from Merck, Pfizer/Lilly. Professor Cooper reports personal fees from Alliance for Better Bone Health, Amgen, Eli Lilly, GSK, Medtronic, Merck, Novartis, Pfizer, Roche, Servier, Takeda, and UCB. Professor Hunter reports personal fees from Merck Serono, Pfizer, Lilly, and TLCBio. Professor Jordan reports grants from National Institutes of Health, Centers for Disease Control and Prevention, American College of Rheumatology, personal fees from Samumed, Flexion, Osteoarthritis Research Society International, and National Institutes of Health. Professor Judge reports personal fees from Anthera Pharmaceuticals Ltd, Freshfields, Bruckhaus, and Derringer. Professor Jones reports personal fees from BMS, Roche, Abbvie, Amgen, Lilly, Novartis, Jannsen, and grants from Covance. Professor Felson has nothing to disclose.
Publisher Copyright:
© 2021, The Author(s).
Keywords:
Knee, Meta-analysis, Mortality, Osteoarthritis
Identifiers
Local EPrints ID: 445656
URI: http://eprints.soton.ac.uk/id/eprint/445656
ISSN: 1594-0667
PURE UUID: 1eb10efb-e8db-47de-97e2-ced104ca7153
Catalogue record
Date deposited: 05 Jan 2021 17:32
Last modified: 18 Mar 2024 05:12
Export record
Altmetrics
Contributors
Author:
Kirsten M. Leyland
Author:
Maria T. Sanchez-Santos
Author:
Michael Nevitt
Author:
David Felson
Author:
Graeme Jones
Author:
Joanne M Jordan
Author:
Andrew Judge
Author:
Dani Prieto Alhambra
Author:
Noriko Yoshimura
Author:
Julia Newton
Author:
Leigh F. Callahan
Author:
Mark Batt
Author:
Jianhao Lin
Author:
Qiang Liu
Author:
Rebecca Cleveland
Author:
Gary Collins
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics
