POS1477-HPR UNDERSTANDING TREATMENT UTILISATION IN INDIVIDUALS WITH OSTEOARTHRITIS AND METABOLIC MULTIMORBIDITY: A CROSS-SECTIONAL STUDY
Authors: F. Recenti, A. Dell’isola, B. Giardulli, M. Testa, M. Ndosi, P. Pchelnikova, S. Battista
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Osteoarthritis (OA) and metabolic conditions are major causes of disability. A growing hypothesis posits the presence of a metabolic OA phenotype where the co-occurrence of OA and metabolic conditions may worsen joint symptoms and overall health. The heightened complexity of the disease status may thus influence the choice of treatments with the possibility that pharmacological and other passive interventions are preferred to exercise and physical activity—the recommended first-line treatment for both OA and diabetes, together with diet when needed. <h3>Objectives:</h3> To explore the utilisation of treatment for OA in individuals with one or more metabolic condition(s) and individuals without metabolic conditions. <h3>Methods:</h3> This cross-sectional web-based survey study was conducted in Italy, Sweden and Russia. Individuals with self-reported OA were invited to participate in the study and were asked which treatments for OA they underwent from a list containing the most common OA treatments (i.e. surgery, electrical physical therapy, NSAIDs, acetaminophen [paracetamol], opioids, antidepressants, corticosteroid injection, hyaluronic acid injection, weight management, exercise, manual therapy, orthosis, natural therapy, homeopathy, education programmes and other physical therapies). In this study, we included people ≥40 years old. We identified two sub-groups: those with self-reported metabolic conditions (hypertension, type II diabetes, obesity [BMI ≥30], and dyslipidaemia) and those without. We estimated the prevalence and the 95% confidence interval (CI) of individuals who utilised a specific treatment separately for individuals with and without metabolic conditions. We then compared the two groups computing the prevalence ratio and its 95% CI for each treatment (prevalence OA and no metabolic conditions used as reference). The prevalences were adjusted for the different age distributions between the two groups using the direct standardisation technique to allow comparison between groups. <h3>Results:</h3> The sample comprised 401 people with OA (Italy: 111; Sweden: 193; Russia: 97; mean age 59.7 [SD:9.8]; years with OA 8.3 [SD:7.5]; female 78.3%), of whom 207 (51.6%) had at least one metabolic condition. Previous use of opioids (prevalence ratio [CI] of 1.8 [1.2-2.4]), antidepressants (1.8 [1.1-2.5]), corticosteroid injections (1.4 [1.1-1.8]) and homeopathic products (2.3 [1.4-3.2]) was higher in individuals with metabolic conditions compared to those without (Table 1). The other treatment modalities showed similar prevalence across groups, with education programs, weight management, and exercise being the most common. <h3>Conclusion:</h3> Our data suggested that individuals with and without metabolic conditions have similar rates of treatment utilisation for OA. Nonetheless pharmacological interventions including opioids, antidepressants, corticosteroid injections and homeopathic products appear to be more prevalent among OA individuals with comorbid metabolic conditions. We hypothesise that this may be due to the heightened joint pain associated with the coexistence of OA and metabolic conditions which may require additional pharmacological management. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> This work was funded by the European Alliance of Associations for Rheumatology (EULAR): The EULAR Health Professionals in Rheumatology (HPR) Research Grant 2020. <h3>Disclosure of Interests:</h3> <b>None declared.</b>