Comorbidities in osteoarthritis (ComOA): a combined cross-sectional, case–control and cohort study using large electronic health records in four European countries
Sita M A Bierma-Zeinstra,
Christian Mallen,
Michael Doherty,
Daniel Prieto-Alhambra,
Chang-Fu Kuo,
Martin Englund,
Carol Coupland,
Weiya Zhang,
Aleksandra Turkiewicz,
Andrea Dell'Isola,
Subhashisa Swain,
Aliya Sarmanova,
Jos Runhaar,
V Strauss,
Anne Kamps,
Danielle Robinson
Affiliations
Sita M A Bierma-Zeinstra
5 Department of General Practice, Erasmus Medical Center, Rotterdam, The Netherlands
Christian Mallen
2 School of Medicine, Keele University, Keele, Staffordshire, UK
Michael Doherty
Pain Centre Versus Arthritis, Nottingham, UK
Daniel Prieto-Alhambra
Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
Chang-Fu Kuo
1Division of Rheumatology, Allergy and Immunology, Taoyuan City, Taiwan, Republic of China
Martin Englund
Clinical Epidemiology Unit, Orthopedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
Carol Coupland
Division of Primary Care, University of Nottingham, Nottingham, UK
Weiya Zhang
Academic Rheumatology, Clinical Sciences Building, University of Nottingham, City Hospital, Nottingham, UK
Aleksandra Turkiewicz
Department of Clinical Sciences, Clinical Epidemiology Unit, Orthopaedics, Lund University, Lund, Sweden
Andrea Dell'Isola
Clinical Epidemiology Unit, Orthopedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
Subhashisa Swain
Academic Rheumatology, University of Nottingham School of Medicine, Nottingham, UK
Aliya Sarmanova
2University of Bristol, Bristol, United Kingdom
Jos Runhaar
Department of General Practice, Erasmus Medical Center, Rotterdam, The Netherlands
V Strauss
Center for Statistics in Medicine, Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford Nuffield, Oxford, UK
Anne Kamps
Department of General Practice, Erasmus MC University Medical Center Rotterdam, The Netherlands, Rotterdam, The Netherlands
Danielle Robinson
Center for Statistics in Medicine, Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford Nuffield, Oxford, UK
Introduction Osteoarthritis (OA) is one of the leading chronic conditions in the older population. People with OA are more likely to have one or more other chronic conditions than those without. However, the temporal associations, clusters of the comorbidities, role of analgesics and the causality and variation between populations are yet to be investigated. This paper describes the protocol of a multinational study in four European countries (UK, Netherlands, Sweden and Spain) exploring comorbidities in people with OA.Methods and analysis This multinational study will investigate (1) the temporal associations of 61 identified comorbidities with OA, (2) the clusters and trajectories of comorbidities in people with OA, (3) the role of analgesics on incidence of comorbidities in people with OA, (4) the potential biomarkers and causality between OA and the comorbidities, and (5) variations between countries.A combined case–control and cohort study will be conducted to find the temporal association of OA with the comorbidities using the national or regional health databases. Latent class analysis will be performed to identify the clusters at baseline and joint latent class analysis will be used to examine trajectories during the follow-up. A cohort study will be undertaken to evaluate the role of non-steroidal anti-inflammatory drugs (NSAIDs), opioids and paracetamol on the incidence of comorbidities. Mendelian randomisation will be performed to investigate the potential biomarkers for causality between OA and the comorbidities using the UK Biobank and the Rotterdam Study databases. Finally, a meta-analyses will be used to examine the variations and pool the results from different countries.Ethics and dissemination Research ethics was obtained according to each database requirement. Results will be disseminated through the FOREUM website, scientific meetings, publications and in partnership with patient organisations.
