1. Osteoarthritis Scott K. Stolte, Pharm.D. Bernard J. Dunn School of Pharmacy Shenandoah University

2. Introduction Most common form of joint disease Affects 20 million Americans of all ages Affects 10% of Americans older than 60 $60 billion/year direct and indirect costs Second to CVD in producing severe, chronic disability 80% have limited mobility 25% cannot perform major ADL’s Common cause of decreased worker productivity and disability

3. Prevalence Prevalence increases with age In US, both sexes equally affected Older women 2x more likely than men to be affected in knees and hands Inflammatory OA more likely in women Involves distal and proximal joints of hands Leads to formation of Heberden’s and/or Bouchard’s nodes

4. Heberden’s nodes Bony prominences at distal interphalangeal joints Similar changes at proximal interphalangeal joints are called Bouchard’s nodes

5. Heberden’s nodes, ctnd.

6. Prevalence Proportion of moderate to severe cases increases with age <45 yo – 19.3% of hands, 23.9% of knees moderate to severe 75-79 yo – 85%, 51% Racial and ethnic differences difficult to establish OA of knee 2x more prevalent in black vs. white women Chinese, East Indian, Native Americans < hip OA than Caucasians

7. Incidence Newly diagnosed OA – 200 cases per 100,000 people per year Approximately 500,000 new, symptomatic cases of idiopathic OA occur annually in the US Caucasian population

8. OA Risk Factors Obesity Increased body mass strongly associated with knee OA, less strongly with hip OA Framingham data People in highest body mass quintile, relative risk of knee OA – 1.5 for men, 2.1 for women 5 kg weight loss lead to a 50% risk reduction in developing symptomatic knee OA

9. Questions