Osteoarthritis

Scott K. Stolte, Pharm.D.Bernard J. Dunn School of Pharmacy

Shenandoah University

Introduction

Most common form of joint disease Affects 20 million Americans of all ages Affects 10% of Americans older than 60 $60 billion/year direct and indirect costs Second to CVD in producing severe,

chronic disability 80% have limited mobility 25% cannot perform major ADL’s

Common cause of decreased worker productivity and disability

Prevalence

Prevalence increases with age In US, both sexes equally affected

Older women 2x more likely than men to be affected in knees and hands

Inflammatory OA more likely in women Involves distal and proximal joints of hands Leads to formation of Heberden’s and/or

Bouchard’s nodes

Heberden’s nodes

Bony prominences at distal interphalangeal joints

Similar changes at proximal interphalangeal joints are called Bouchard’s nodes

Heberden’s nodes, ctnd.

Prevalence

Proportion of moderate to severe cases increases with age <45 yo – 19.3% of hands, 23.9% of knees

moderate to severe 75-79 yo – 85%, 51%

Racial and ethnic differences difficult to establish OA of knee 2x more prevalent in black vs.

white women Chinese, East Indian, Native Americans <

hip OA than Caucasians

Incidence

Newly diagnosed OA – 200 cases per 100,000 people per year

Approximately 500,000 new, symptomatic cases of idiopathic OA occur annually in the US Caucasian population

OA Risk Factors

Obesity Increased body mass strongly associated

with knee OA, less strongly with hip OA Framingham data

People in highest body mass quintile, relative risk of knee OA – 1.5 for men, 2.1 for women

5 kg weight loss lead to a 50% risk reduction in developing symptomatic knee OA

Questions