Asthma and eczema linked to increased OA risk

3 minute read

Drugs that dampen the physiological prompts for allergic reactions in the body may have a protective benefit, researchers suggest.

Atopic diseases like asthma or eczema may increase the risk of osteoarthritis by nearly 60%, a new study has revealed.

In the retrospective cohort study, researchers looked at about 117,000 people with allergic asthma or eczema (average age 52; 60% women) and 1.25 million people age-matched controls over eight years and found the risk of developing osteoarthritis was 58% higher in those with allergic asthma or eczema than it was among those without atopic disease.

This trend was even more noticeable among the 4000 people with both allergic asthma and eczema, who were twice as likely to develop osteoarthritis as those without atopic disease, said researchers in the Annals of the Rheumatic Diseases.

Close to 12,000 people with allergic asthma alone were 83% more likely to develop osteoarthritis over the eight years than those with chronic obstructive pulmonary disease, a lung disease that doesn’t involve allergic pathways.

The researchers acknowledge various limitations to their findings, including reliance on insurance claims data for part of the study – these didn’t include information on potentially influential factors, such as BMI, previous joint injury or physical activity levels.

Nevertheless, the researchers concluded that patients with atopic disease have an increased risk of developing osteoarthritis compared with the general population.

“The association between atopic disease and osteoarthritis is supported by recent observations that mast cells and type II cytokines may play important roles in the pathogenesis of osteoarthritis broadly, not just in patients with atopic disease,” the study authors wrote.

The researchers said their findings provided further support for the use of drugs that dampen down the physiological prompts for allergic reactions in the body to lessen this risk.

“Mounting evidence suggests that activation of … mast cells and inflammatory chemicals [cytokines] involved in allergic reactions may have key roles in the development of osteoarthritis,” the authors wrote.

Lead author Dr Matthew Baker, from Stanford University, told Rheumatology Republic that while the research didn’t investigate ways to modify disease risk, previous research supported the use of treatments that inhibit mast cells and allergic cytokines to treat or prevent OA.

“In prior work, we have found that both atopic and non-atopic patients with osteoarthritis have increased numbers and activity of mast cells in the joint contributing to osteoarthritis pathogenesis,” he said.

“Thus, we are hopeful that pharmacological interventions directed against mast cells and their mediators or activators [such as tryptase, histamine, Immunoglobulin E] could help all patients with osteoarthritis, not just atopic patients.”

Dr Baker pointed to another study, presented at last year’s EULAR meeting, that found the use of antihistamines was associated with reduced structural progression in knee osteoarthritis.

“Our findings provide further support for the concept that allergic pathways may contribute to the development of osteoarthritis.

“If this is indeed true, non-atopic patients may also benefit from the use of treatments that inhibit mast cells and allergic cytokines to treat or prevent osteoarthritis.”

“We are hopeful that any number of drugs that work to inhibit mast cells or mast cell products [such as histamine] will reduce the incidence of OA in these patients, but this needs to be studied in a prospective manner,” he told RR.

Ann Rheum Dis 2023, online 27 March

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