Erosive hand osteoarthritis tied to articular structural damage and its progression: Study
Erosive hand osteoarthritis (EHOA) is a lesser-known type of osteoarthritis that affects approximately 3 per cent of people over 55 and 10 per cent of those with symptomatic hand OA. In a study, researchers have found that EHOA predominantly affects older adults and women with preexisting OA and are linked with severe articular structural damage and radiographic progression. The study findings were published in the journal Arthritis & Rheumatology on April 12, 2021.
The unique characteristics of EHOA suggest that pathological processes differ from those of typical hand OA (HOA). Dr Timothy E. McAlindon and colleagues wrote, "Better understanding the fundamental nature of EHOA could help clarify these processes and uncover potential therapeutic targets." Therefore, Dr McAlindon and his team conducted a study to evaluate age, sex, race, osteoarthritis severity, metabolic factors, and bone health as risk factors for incident erosive hand osteoarthritis (EHOA) at baseline and over 48 months.
It was a longitudinal cohort study of 3365 individuals from the Osteoarthritis Initiative with complete hand radiographs from baseline and 48-month visits. The researchers classified the individuals as having EHOA if they had Kellgren-Lawrence (KL) grade≥2 in at least one interphalangeal joint on two different fingers and central erosion in at least one joint.
Key findings of the study were:
- Among 3365 individuals, the researchers noted that 86 (2.6%) individuals developed EHOA during the 48 months.
- They found that older age (relative risk [RR] per standard deviation = 0.76), female sex (RR = 1.73), greater OA severity (sum of KL grade 13.9 vs 5.3,) and less cortical width (1.38 vs 1.52 mm) increases the risk of EHOA.
- After 48 months of follow up, they noted that individuals who developed EHOA were characterized by greater progressions of radiographic osteoarthritis. This includes joint space narrowing, KL grade progression (RRs = 1.35-1.9) and loss of cortical thickness (RR = 1.23), all adjusted for age, sex, race and BMI.
The authors concluded, "These findings present EHOA as a disorder of advanced age and female sex, strongly associated with severity of articular structural damage and its progression. Individuals who develop EHOA have thinner bones prior to EHOA development and as it progresses, suggesting EHOA as a disorder of skeletal frailty."
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