Osteoarthritis

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Osteoarthritis

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

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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 ADLs
• Common cause of decreased worker productivity and
  disability

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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 Heberdens and/or
  Bouchards nodes

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Heberdens nodes
Bony prominences at distal interphalangeal
joints Similar changes at proximal
interphalangeal joints are called Bouchards nodes
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Heberdens nodes, ctnd.
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Prevalence

• Proportion of moderate to severe cases increases
  with age
• lt45 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 lt hip OA
  than Caucasians

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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

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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

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Questions