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Having Asthma, Eczema Might Raise Arthritis Risk

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As researchers, we have found that individuals suffering from allergic asthma or eczema might be at a higher risk of developing osteoarthritis as they age. Our study aimed to investigate the potential connection between these two allergic conditions and the likelihood of developing osteoarthritis, a common form of arthritis caused by wear and tear.

Although our study was not designed to determine how or if these allergic diseases contribute to an increased risk of osteoarthritis, we have developed a theory based on our previous work. Our research group discovered that the number of mast cells, a type of allergic cell, is higher in the joints of individuals with osteoarthritis, and their activity contributes to the development of the condition. We believe that asthma and eczema could be part of a larger pattern of atopic conditions, such as seasonal allergies, food allergies, and allergic rhinitis (hay fever), that may also elevate the risk of osteoarthritis.

To better understand this potential link, we conducted a study that analyzed insurance claims from two separate databases. The first set included data on over 117,000 individuals with asthma or eczema and 1.2 million without these conditions. After an eight-year follow-up period, we found that the risk of developing osteoarthritis was 58% higher in those with allergic asthma or eczema compared to those without these allergic conditions. Furthermore, the risk of osteoarthritis was even higher for individuals with both allergic asthma and eczema.

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We also compared the risk of developing osteoarthritis in individuals with allergic asthma to those with chronic obstructive pulmonary disease (COPD), a lung disease that does not involve allergic pathways. Our findings showed that individuals with asthma were 83% more likely to develop osteoarthritis than those with COPD.

In the second database, the odds of developing osteoarthritis were 42% higher among individuals with either allergic asthma or eczema and 19% higher among those with both conditions. These findings were not as robust as those observed in the first set, as they took body mass index (BMI) into account, which is a known risk factor for developing osteoarthritis.

A critical question arising from our study is whether treating asthma or eczema could lower the risk of arthritis. While our research did not explore this aspect, there is some evidence to suggest that it might be possible. Older studies have linked the use of antihistamines with reduced structural progression in knee osteoarthritis. We are hopeful that drugs that inhibit mast cells or mast cell products, such as histamine, could reduce the incidence of osteoarthritis.

We are hopeful that any number of drugs that work to inhibit mast cells or mast cell products [such as histamine] will reduce the incidence of osteoarthritis

Our study, funded by the U.S. National Institutes of Health and published in the Annals of the Rheumatic Diseases, suggests that low-grade inflammation could be a common factor connecting osteoarthritis and allergic diseases. The good news is that there are more treatments for eczema than ever before, and many more are being developed.

It is crucial for patients with eczema or asthma to be aware of their increased risk of developing osteoarthritis. If individuals with allergic diseases experience joint aches and pains, we advise them to consult their doctors. Although there are no disease-modifying treatments for osteoarthritis yet, numerous strategies can help improve its symptoms. Our study provides hope that treating atopic diseases might prevent or reduce the potential for individuals with eczema or asthma to develop osteoarthritis.

William H. McDaniel, MD

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School.

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