Degenerative joint disease is one of the leading causes of pain and disability among adults worldwide. In the United Kingdom, around 8.5 million people suffer daily from the consequences of this disease and it is estimated that this number, together with its costs, will continue to rise in the future. Since current treatment options cannot slow or alter the progression of degenerative joint disease, a substantial challenge to healthcare systems is posed. Consequently, it remains crucial to discover effective therapies that can interfere with the development of degenerative joint disease. Exploring new therapeutic uses for existing drugs could provide efficient opportunities.
Therefore, this study aims to investigate existing drugs that hold the potential to be used for the treatment of degenerative joint disease. The objectives are to examine the associations of already available drugs (including those commonly used for the prevention of hip fracture, treatment of painful joints and diabetes) with incident degenerative hip or knee disease.
In this retrospective cohort study, patients aged 18 years and over and diagnosed with the condition(s) the treatment is used for (i.e. those at increased risk of sustaining a hip fracture, painful joints and diabetes) will be included. The risk of incident degenerative knee or hip disease will be estimated and the influence of the duration of treatment will be assessed.
Osteoarthritis is one of the leading causes of pain and disability among adults worldwide. Management of osteoarthritis focusses on the reduction of pain and optimalisation of function, but no disease modifying osteoarthritis drugs are currently available. Drug repurposing offers an intriguing opportunity as it is an efficient strategy to provide new treatment options.
Therefore, this study aims to investigate promising marketed drugs that hold the potential to be repurposed for the treatment of osteoarthritis. The objectives are to examine the associations of bisphosphonates, colchicine, allopurinol, and metformin with incident knee or hip osteoarthritis.
For this purpose, patients aged 18 years and over with a SNOMED code for the condition the treatment is used for between January 1987 and December 2023 will be included. Patients will be considered unexposed between the index date and the moment they have been prescribed their first prescription of treatment of interest or if they have not been prescribed treatment of interest in 12 months before the index date and have not been prescribed treatment of interest after the index date. Patients will be considered exposed the moment they have been prescribed their first prescription of the treatment of interest after the index date. The index date will be defined as the date of diagnosis of the condition the treatment is used for. The primary outcome will be the first record of knee or hip osteoarthritis after diagnosis of the condition the treatment is used for. Propensity scores will be estimated using multivariable logistic regression. A Cox proportional hazard model where propensity scores will be considered as covariate will be used to estimate hazard ratios and 95% confidence intervals. Subgroup analyses will be performed using timing of drug initiation and cessation as well as using the treatment period as a proxy for the cumulative dosage.
First recorded diagnosis of knee osteoarthritis or hip osteoarthritis.
Arief Lalmohamed - Chief Investigator - Utrecht University
Arief Lalmohamed - Corresponding Applicant - Utrecht University
Bart Van den Bemt - Collaborator - Sint Maartenskliniek
Calin Popa - Collaborator - Sint Maartenskliniek
Cornelia (Els) Van den Ende - Collaborator - Sint Maartenskliniek
Michelle Heijman - Collaborator - Sint Maartenskliniek
Patrick Souverein - Collaborator - Utrecht University