Use of Vitamin K antagonist anticoagulant may increase risk of osteoarthritis: BMJ

Vitamin K is hypothesised to play a role in osteoarthritis (OA) pathogenesis through effects on vitamin K-dependent bone and cartilage proteins, and therefore may represent a modifiable risk factor. A genetic variant in a vitamin K-dependent protein that is an essential inhibitor for cartilage calcification, matrix Gla protein (MGP), was associated with an increased risk for OA. Vitamin K antagonist anticoagulants (VKAs), such as warfarin and acenocoumarol, act as anticoagulants through inhibition of vitamin K-dependent blood coagulation proteins. Vitamin K antagonist anticoagulants (VKAs) likely also affect the functioning of other vitamin K-dependent proteins such as matrix Gla protein (MGP).

A group of researchers from U.S.A and Netherlands investigated the effect of acenocoumarol usage on progression and incidence of radiographic osteoarthritis (OA) in 3494 participants of the Rotterdam Study cohort. They also examined the effect of matrix Gla protein (MGP) and VKORC1 single nucleotide variants on this association.

The results of the study are as follows:

• Acenocoumarol usage was associated with an increased risk of OA incidence and progression, both for knee and hip OA.
• Among acenocoumarol users, carriers of the high VKORC1(BB) expression haplotype together with the matrix Gla protein (MGP) osteoarthritis (OA) risk allele had an increased risk of osteoarthritis (OA) incidence and progression, while this the relationship was not present in non-users of that group.

The researchers concluded that these findings support the importance of vitamin K and vitamin K-dependent proteins, as MGP, in the pathogenesis of osteoarthritis (OA). Additionally, these results may have direct implications for the clinical prevention of osteoarthritis (OA), supporting the consideration of direct oral anticoagulants in favour of Vitamin K antagonist anticoagulants (VKAs).

Reference:

Vitamin K antagonist anticoagulant usage is associated with increased incidence and progression of osteoarthritis by Boer C et. al published in the Annals of the Rheumatic Diseases- BMJ

https://ard.bmj.com/content/80/5/598