Triggers for acute flare in adults with, or at risk of, knee osteoarthritis: a web-based case-crossover study in community-dwelling adults.
Osteoarthritis Cartilage
; 29(7): 956-964, 2021 07.
Article
em En
| MEDLINE
| ID: mdl-33933585
ABSTRACT
OBJECTIVE:
To identify proximate causes ('triggers') of flares in adults with, or at risk of, knee osteoarthritis (OA), estimate their course and consequences, and determine higher risk individuals.METHODS:
In this 13-week web-based case-crossover study adults aged ≥40 years, with or without a recorded diagnosis of knee OA, and no inflammatory arthropathy who self-reported a knee flare completed a questionnaire capturing information on exposure to 21 putative activity-related, psychosocial and environmental triggers (hazard period, ≤72 h prior). Comparisons were made with identical exposure measurements at four 4-weekly scheduled time points (non-flare control period) using conditional logistic regression. Flare was defined as a sudden onset of worsening signs and symptoms, sustained for ≥24 h. Flare characteristics, course and consequence were analysed descriptively. Associations between flare frequency and baseline characteristics were estimated using Poisson regression.RESULTS:
Of 744 recruited participants (mean age [SD] 62.1 [10.2] years; 61% female), 376 reported 568 flares (hazards) and provided 867 valid control period measurements. Thirteen exposures (eight activity-related, five psychosocial/environmental) were positively associated with flare onset within 24 h (strongest odds ratio estimate, knee buckling 9.06 95% confidence interval [CI] 5.86, 13.99; weakest, cold/damp weather 1.45 95%CI 1.12, 1.87). Median flare duration was 5 days (IQR 3, 8), less common if older (incident rate ratio [IRR] 0.98 95%CI 0.97, 0.99), more common if female (IRR 1.85 95%CI 1.43, 2.39).CONCLUSIONS:
Multiple activity-related, psychosocial and environmental exposures are implicated in triggering flares. This evidence can help inform prevention and acute symptom management for patients and clinicians.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Osteoartrite do Joelho
/
Exacerbação dos Sintomas
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article