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NSAID Use, Gastrointestinal Complications, and Burden of Disease in Osteoarthritis: Nordic Registry Study with Emphasis on Patients Below 60 Years

Year: 2025

Type: article

Abstract: Osteoarthritis (OA) is associated with joint pain and disability, with increasing prevalence and economic burden. This study explored non-steroidal anti-inflammatory drugs (NSAID) treatment patterns, gastrointestinal (GI) complications and burden of disease in patients with OA based on Nordic registry data, with emphasis on individuals aged 60 or younger. This non-interventional observational study analysed registry data from Norway, Finland, and Sweden. Adults with primary OA diagnosis in specialty care were matched 1:1 by age and sex with individuals of the general population. The primary outcome was NSAID treatment patterns, assessed by dispensations and daily defined doses (DDD) 1 year before and after diagnosis. Secondary outcomes included prevalence of comorbidities, the incidence of GI complications, sick leave, and joint replacements. The study included 189,553 patients with OA from Norway, 341,548 from Sweden, and 218,253 from Finland, 34.1% to 40.4% aged ≤ 60. About half of patients had NSAIDs dispensed before and after diagnosis, (Norway 56.6% and 48.6%; Sweden 50.1% and 44.0%; Finland 58.8% and 58.2%), compared to about one-fifth of the matches (Norway 19.1% and 18.5%; Sweden 12.7% and 12.2%; Finland 22.5% and 21.7%). NSAID use increased with age until approximately 55 years, then declined. After diagnosis, fewer patients had NSAID dispensations, but mean DDDs per prescription were generally higher. Secondary analyses showed a higher comorbidity burden, higher rates of GI complications, more sick leave days, and more joint replacements in patients with OA than in matched individuals. Across Nordic countries, patients with OA had more NSAID dispensations, and GI complications were more prevalent compared to matched individuals. Notably, this was already evident in younger patients under the age of 60, underscoring the need for comprehensive GI risk assessment for every patient with OA. The substantial burden of OA was also evidenced by considerable numbers of sick leave days and joint replacements. Osteoarthritis (OA) is a condition that causes joint pain and disability, currently becoming more common and costly. This study evaluated how people with OA in Norway, Sweden, and Finland use non-steroidal anti-inflammatory drugs (NSAIDs), experience gastrointestinal (GI) complications, and deal with the overall impact of OA, with emphasis on patients aged 60 or younger. Researchers used data from national registries to compare adults with OA to people of same age and sex from the general population. They examined NSAID use, GI complications, sick leave, and joint replacements 1 year before and after diagnosis. The study included over 749,000 patients with OA. About 34.0–40.0% of them were 60 or younger. Patients with OA had more health issues than the general population. About half of them used NSAIDs before and after diagnosis, while only one-fifth of the general population did. GI complications were more common in patients with OA (up to 4.0%) than in the general population (up to 2.6%), increasing with age. Working-age patients with OA had many more sick leave days before and after diagnosis compared to the general population. Patients with OA also had more hip or knee joint replacements, especially after diagnosis. Patients with OA in Nordic countries use more NSAIDs and have more GI complications than the general population, even those under 60, showing the need for personalized treatment. The significant impact of OA is also shown by the high number of sick leave days and joint replacements compared to the general population.

Source: Rheumatology and Therapy

DOI: 10.1007/s40744-025-00803-4