OBJECTIVES: There is still a large unmet need for novel osteoarthritis (OA) treatments that could provide clinically important effects on long-term pain relief (>/=12 months). We examined the relation of bariatric surgery along with weight loss to analgesic prescription and all-cause mortality among individuals with OA.
METHODS: We conducted a cohort study among individuals with OA using The Health Improvement Network. We compared the rate of no analgesic prescription >/=12 consecutive months and the risk of all-cause mortality using inverse probability weighting Cox-proportional hazard models and the difference in number of analgesic prescriptions (non-steroidal anti-inflammatory drugs, opioids, and paracetamol) in the 50(th), 75(th) and 90(th) percentiles using quantile regression model between bariatric and non-bariatric cohorts.
RESULTS: Included were 588,494 individuals (694 had bariatric surgery). Compared with non-bariatric group, the rate of no analgesic prescription >/=12 consecutive months was higher (HR = 1.23, 95% CI: 1.08-1.38) in bariatric surgery group, and the number of analgesic prescriptions was lower in the 75(th) (44 vs 58) and 90(th) (74 vs 106) percentiles during a mean follow-up of 4.3 years. All-cause mortality in bariatric surgery group was lower than comparison group (HR = 0.46, 95% CI: 0.41-0.51).
CONCLUSION: This study presents the first evidence that bariatric surgery was associated with decreased long-term analgesic prescription and decreased all-cause mortality among individuals with OA. However, our findings may be overestimated owing to intractable confounding by indication for bariatric surgery; thus, future studies (e.g., clinical trials) are warranted.
|投稿者||Zeng, C; Lane, N E; Li, X; Wei, J; Lyu, H; Shao, M; Lei, G; Zhang, Y|
|組織名||Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha,;China. Electronic address: firstname.lastname@example.org.;Division of Rheumatology, Allergy and Clinical Immunology, Department of;Medicine, University of California, Davis, CA, USA. Electronic address:;email@example.com.;Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, China.;Electronic address: firstname.lastname@example.org.;Health Management Center, Xiangya Hospital, Central South University, Changsha,;China. Electronic address: email@example.com.;China; Department of Orthopedics, General Hospital of Chinese PLA, Beijing,;China. Electronic address: firstname.lastname@example.org.;Department of Gastrointestinal Surgery, Xiangya Hospital, Central South;University, Changsha, China. Electronic address: email@example.com.;China; Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, China;;National Clinical Research Center for Geriatric Disorders, Xiangya Hospital,;Central South University, Changsha, China. Electronic address:;firstname.lastname@example.org.;Division of Rheumatology, Allergy, and Immunology, Department of Medicine,;Massachusetts General Hospital, Harvard Medical School, Boston, USA; The Mongan;Institute, Massachusetts General Hospital, Harvard Medical School, Boston, USA.;Electronic address: email@example.com.|