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Journal of Peking University(Health Sciences) ›› 2018, Vol. 50 ›› Issue (6): 1044-1048. doi: 10.19723/j.issn.1671-167X.2018.06.018

• Article • Previous Articles     Next Articles

A multi-center cross-sectional survey of medicine application in patients with osteoarthritis in China

Xiao-ying ZHANG1,Jia-jing PENG1,Chuan-hui LIU2,Xiao-yan CAI3,Jiang-lin ZHANG4,Yi-fang MEI5,Hong-tao JIN6,Xiao-fei WANG7,Hong MO8,Zhan-guo LI1,△()   

  1. 1. Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing 100044, China
    2. Department of Rheumatology and Immunology, Zhengzhou Orthopaedics Hospital, Zhengzhou 450052, China
    3. Department of Rheumatology and Immunology, Guangzhou First People’s Hospital, Guangzhou 510180, China
    4. Department of Rheumatology and Immunology, Chinese PLA General Hospital, Beijing 100039, China
    5. Department of Rheumatology and Immunology, The First Hospital of Harbin Medical University, Harbin 150001, China
    6. Department of Rheumatology and Immunology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
    7. Department of Rheumatology and Immunology, Shengjing Hospital of China Medical University, Shenyang 110004, China
    8. Department of Rheumatology and Immunology, Nanning First People’s Hospital, Nanning 530022, China
  • Received:2018-08-04 Online:2018-12-18 Published:2018-12-18
  • Contact: Zhan-guo LI E-mail:li99@bjmu.edu.cn

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Abstract:

Objective: To investigate the clinical characteristics, the medicine application and to eva-luate the disease activity in patients with osteoarthritis (OA) in China.Methods:This was a cross-sectional study. Totally 1 066 cases of OA from 40 hospitals in China from April to October 2017 were retrospectively enrolled. Demographic characteristics, clinical data, medicine application, and joint function were evaluated. All the data were analyzed by SPSS software 19.0. t test, Mann-Whitney U test and chi-square test were used for statistical analysis.Results:In the 1 066 cases, the male-to-female ratio was 1 :3.6 and the average age was (61.9±11.0) years, with an age range from 36 to 94 years. The incidence of knee OA, hip OA, and hand OA were respectively 81.9% (873/1 066), 14.1% (150/1 066), and 36.3% (387/1 066). In the study, 242 (22.7%) cases had two kinds of joint areas involved and three joint areas were involved in 51 cases (4.8%), and 56.6% (603/1 066) of the patients used more than one kind of non- steroid anti-inflammatory drugs (NSAIDs) while 61.2% (652/1 066) used disease modifying osteoarthritis drugs (DMOADs), including glucosamine (37.5%, 400/1 066), chondroitin sulfate (2.0%, 21/1 066), diacetate (5.9%, 63/1 066), and the combination of these drugs (15.8%, 168/1 066). 8.6% (92/1 066) patients only took analgesics to relieve the pain, not using any kind of NSAIDs or DMOADs. And 232 patients (21.7%) had intra-articular injections, including 9.2% (98/1 066) sodium hyaluronate, 4.5%(48/1 066) glucocorticoid, and 8.1% (86/1 066) combination of the two drugs. The proportion of the patients taking topical drugs accounted for 26.5% (283/1 066) and physical therapy accounted for 15.8% (168/1 066). Compared with those who suffered from knee OA, the patients who suffered from hip OA had more severe disease assessment. Moreover, there were significant differences in pain (Z=-7.625, P<0.001), morning stiffness (Z=-6.229, P<0.001), and joint function (Z=-6.777, P<0.001) between the two groups of the patients who suffered from knee or hip OA with The Western Ontario and McMaster Universities (WOMAC) osteoarthritis index. Furthermore, patients with hip OA took more analgesics (χ 2=24.838, P<0.001). Conclusion:Oral NSAIDs and DMOADs are wildly used in patients with OA in China. However, the treatment of some patients still need to be improved. Patients with hip OA are more seriously ill and require aggressive treatment.

Key words: Osteoarthritis, Drug therapy, Cross-sectional study

CLC Number: 

  • R593

Table 1

Demographic characteristics of 1 066 osteoarthritis patients"

Items Patients, n(%)
Gender
Female 836 (78.4)
Male 230 (21.6)
Age/years
<45 51 (4.8)
45-<60 402 (37.7)
60-<80 536 (50.3)
≥80 75 (7.0)
Body mass index/(kg/m2)
<18.5 42 (3.9)
18.5-<25.0 561 (52.6)
25.0-<30.0 367 (34.4)
≥30.0 69 (6.5)
Duration/months
<12 225 (21.1)
12-<60 364 (34.1)
60-<120 209 (19.6)
≥120 257 (24.1)
Smoking status
Never smoked 932 (87.4)
Current smoker 80 (7.5)
Ex-smoker 42 (3.9)
Family history
Yes 104 (9.8)
None 944 (88.6)

Table 2

Therapeutics status of 1 066 osteoarthritis patients"

Therapeutics Patients, n(%)
NSAIDs 603 (56.6)
Analgesic 308 (28.9)
DMOADs
Glucosamine 400 (37.5)
Chondroitin 21 (2.0)
Diacerein 63 (5.9)
Combined 2 DMOADs or more 168 (15.8)
Surgical
Arthroplasty 14 (1.3)
Arthroscopy 17 (1.6)
Intra-articular injections
Glucocorticoid 48 (4.5)
Hyaluronate 98 (9.2)
Combined 86 (8.1)
Topical medications 283 (26.5)
Physical therapy 168 (15.8)

Table 3

Clinical characteristics of 909 patients with knee and hiposteoarthritis"

Items Knee OA group (n=759) Hip OA group (n=150) t/Z/χ2 P value
Female, n(%) 602 (73.9) 113 (75.3) 1.183 0.277
Age/years, x-±s 61.4±10.8 65.1±12.2 -3.486 0.001
BMI/(kg/m2), x-±s 24.4±3.4 24.0±3.9 1.284 0.201
Duration/months, median (IQR) 36 (12,108) 60 (22.5,120.0) -2.847 0.004
Assessment from patients/cm, median (IQR) 5 (3,7) 6.0 (4.0,7.1) -4.374 <0.001
Assessment fromphysicians/cm, median (IQR) 5 (3,6) 5.25 (4.0,7.0) -4.719 <0.001
WOMAC score, median (IQR)
Pain 30.0 (11.8,46.0) 48.0 (30.0,63.5) -7.625 <0.001
Stiffness 20.0 (7.5,40.0) 37.5 (20.0,55.0) -6.229 <0.001
Function 28.2 (11.8,49.3) 45.9 (30.3,60.6) -6.777 <0.001
Treatment, patients
NSAIDs, n(%) 414 (54.5) 94 (62.7) 3.351 0.067
Analgesic, n(%) 204 (26.8) 71 (47.3) 24.838 <0.001
DMOADs, n(%) 474 (62.5) 96 (64.0) 0.129 0.720
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