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Abstract Number: 1028

Knee Osteoarthritis and Mortality: The Osteoarthritic Initiative

Jane Cauley1, Michael Nevitt2, Kai Sun3, Jason Maeda3, C. Kent Kwoh4, Leena Sharma5, Rebecca Jackson6, Susan Rubin3 and Marc Hochberg7, 1University of Pittsburgh Graduate School of Public Health, Pittsbugh, PA, 2University of California San Francisco, Orinda, CA, 3University of California San Francisco, San Francisco, CA, 4University of Arizona College of Medicine, Tuscon, AZ, 5Northwestern University, Chicago, IL, 6Ohio State University, Columbus, OH, 7University of Maryland School of Medicine, Baltimore, MD

Meeting: ACR Convergence 2021

Keywords: Mortality, OAI, Osteoarthritis

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Session Information

Date: Monday, November 8, 2021

Session Title: Epidemiology & Public Health Poster III: Other Rheumatic & Musculoskeletal Diseases (1022–1060)

Session Type: Poster Session C

Session Time: 8:30AM-10:30AM

Background/Purpose: A recent international individual participant data (IPD) meta-analysis (n=10,723) reported a 35-37% increased mortality risk among individuals with painful knees (no radiographic OA) and symptomatic radiographic knee OA (Leyland K et al 2021). We examined whether these results could be replicated in the Osteoarthritis (OAI) cohort (not included in the international IPD) using complete, long-term data on participant deaths from the OAI.

Methods: The OAI is a prospective cohort study investigating risk factors and biomarkers associated with the development and progression of knee OA. A total 4,796 adults age 45-79 years with or at high risk of developing knee OA were recruited at five US clinical sites. A National Death Index search was initiated to identify all deaths from 2004-2018. We used OAI baseline data on radiographic knee OA (K-L grade >=2), knee symptoms (pain on most days of a month in past year) and symptomatic OA (radiographic OA and symptoms in the same knee) to classify participants into four groups: symptomatic OA in one or both knees; no symptomatic OA but has radiographic OA in one or both knees; no radiographic OA but has symptoms in one or both knees; no radiographic OA or symptoms in either knee (referent group). Cox proportional hazards models were used to calculate hazard ratios (HR) for mortality, and their 95% confidence Intervals (CI), adjusted for covariates, in each group compared to the referent group. We excluded those who had a knee replacement at baseline (n=63) and missing data on covariates.

Results: The mean age of the cohort at baseline was 61 years; 80% were white; 58% were women. Over an average follow-up of 9.2 years, 515 (11.3%) died. Of those with no radiographic OA and no symptoms, 9.7% died; no radiographic OA with symptoms, 8.2% died; radiographic OA and no symptoms, 13.4% died and radiographic OA and symptoms, 12.5% died, p< 0.0005, See Table. In multivariable adjusted models there was a marginally significant 28% increase in mortality (p=0.065) in participants with symptomatic knee OA at baseline. The association with mortality was stronger in those with symptomatic knee OA with a K-L grade 3 or 4 HR= 1.32 (1.00, 1.73) compared with those symptomatic OA with K-L score of 2, HR=1.17(0.85, 1.63). We also examined the association between frequent knee symptoms in either knee, adjusting for K-L grade; those with frequent knee pain had an increased risk of death, HR= 1.19 (0.99, 1.43).

Conclusion: These results with complete long-term follow-up data from the OAI cohort are consistent with those from the individual level meta-analysis showing increased mortality among those with symptomatic knee OA.


Disclosures: J. Cauley, None; M. Nevitt, None; K. Sun, None; J. Maeda, None; C. Kwoh, Lilly, 5, Abbvie, 5, Kolon Tissue Gene, 12, DSMB, Regeneron, 1, LG Chem, 1; L. Sharma, None; R. Jackson, None; S. Rubin, None; M. Hochberg, BriOri Biotech, 1, 2.

To cite this abstract in AMA style:

Cauley J, Nevitt M, Sun K, Maeda J, Kwoh C, Sharma L, Jackson R, Rubin S, Hochberg M. Knee Osteoarthritis and Mortality: The Osteoarthritic Initiative [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/knee-osteoarthritis-and-mortality-the-osteoarthritic-initiative/. Accessed January 31, 2023.
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