Arthropathy

Statins and Musculoskeletal Conditions, Arthropathies, and Injuries.

Posted by

0


ABSTRACT

Importance  Statin use may be associated with increased musculoskeletal adverse events, especially in physically active individuals.

Objective  To determine whether statin use is associated with musculoskeletal conditions, including arthropathy and injury, in a military health care system.

Design  A retrospective cohort study with propensity score matching.

Setting  San Antonio Military Multi-Market.

Participants  Tricare Prime/Plus beneficiaries evaluated from October 1, 2003, to March 1, 2010.

Interventions  Statin use during fiscal year 2005. On the basis of medication fills, patients were divided into 2 groups: statin users (received a statin for at least 90 days) and nonusers (never received a statin throughout the study period).

Main Outcomes and Measures  Using patients’ baseline characteristics, we generated a propensity score that was used to match statin users and nonusers; odds ratios (ORs) were determined for each outcome measure. Secondary analyses determined adjusted ORs for all patients who met study criteria and a subgroup of patients with no comorbidities identified using the Charlson Comorbidity Index. Sensitivity analysis further determined adjusted ORs for a subgroup of patients with no musculoskeletal diseases at baseline and a subgroup of patients who continued statin therapy for 2 years or more. The occurrence of musculoskeletal conditions was determined using prespecified groups of International Classification of Diseases, Ninth Revision, ClinicalModification codes: Msk1, all musculoskeletal diseases; Msk1a, arthropathies and related diseases; Msk1b, injury-related diseases (dislocation, sprain, strain); and Msk2, drug-associated musculoskeletal pain.

Results  A total of 46 249 individuals met study criteria (13 626 statin users and 32 623 nonusers). Of these, we propensity score–matched 6967 statin users with 6967 nonusers. Among matched pairs, statin users had a higher OR for Msk1 (OR, 1.19; 95% CI, 1.08-1.30), Msk1b (1.13; 1.05-1.21), and Msk2 (1.09; 1.02-1.18); the OR for Msk1a was 1.07 (0.99-1.16; P = .07). Secondary and sensitivity analyses revealed higher adjusted ORs for statin users in all outcome groups.

Conclusions and Relevance  Musculoskeletal conditions, arthropathies, injuries, and pain are more common among statin users than among similar nonusers. The full spectrum of statins’ musculoskeletal adverse events may not be fully explored, and further studies are warranted, especially in physically active individuals.

Source: JAMA

Cartilage Gives Early Warning of Arthritis, Study Finds.

Posted by

0


knee-osteoarthritisDamage to the tissue that cushions joints occurs even before people feel pain, research shows.

By Robert Preidt, HealthDay News

Exercise-related damage in cartilage can help identify people with the earliest stages of osteoarthritis, a new study reveals.

The findings could improve early detection of the painful joint disease and could also be used to improve methods of repairing damaged cartilage, said study senior author Alan Grodzinsky, of the Massachusetts Institute of Technology, and colleagues.

For the study, the researchers developed a method that identifies osteoarthritis-related changes that occur in cartilage in response to high-load activities such as running and jumping.

Cartilage is firm, rubbery tissue that cushions bones and keeps them from rubbing together. When osteoarthritis begins to develop, the ability of cartilage to resist physical-activity-related impact is reduced. This is now known to be due to the loss of molecules called glycosaminoglycans (GAGs)

Using their new system, the researchers found that GAG-depleted cartilage loses its ability to stiffen under the forces of high-load activities. GAG loss also caused an increase in the depletion of fluids from the cartilage, which likely reduces protection against the impact of high-load activities.

The findings show how GAG loss at the earliest disease stages reduces the ability of this tissue to withstand high-load activities, according to the study, which was published in the April 2 issue of theBiophysical Journal.

“This finding suggests that people with early degradation of cartilage, even before such changes would be felt as pain, should be careful of dynamic activities such as running or jumping,” Grodzinsky said in a journal news release.

Osteoarthritis affects about one-third of older adults and is the most common type of joint disorder.