This study examined whether atopy (defined as history of asthma and/or atopic dermatitis) is associated with symptomatic and structural severity of knee and/or hip OA in 717 adults from the French KHOALA cohort, with up to 7 years of follow-up.
Atopy was associated with a 2.46-fold higher odds of end-stage radiographic OA (KL grade 4; 42% vs. 24% in non-atopic patients; adjusted OR 2.46, 95% CI 1.42–4.25, P=0.001) and a near doubling of total knee replacement risk over 7 years (HR 1.99, 95% CI 1.15–3.45, P=0.01). Unadjusted WOMAC pain scores were higher in atopic patients (7.6/20 vs. 6.4/20, P<0.05), but this did not survive adjustment.
- Small atopic subgroup (n=66, ~9% of cohort), limiting statistical power and subgroup analyses by atopic condition. - Atopy was defined broadly by self-reported history of asthma and/or atopic dermatitis, without objective allergy testing or IgE measurement. - Observational design precludes causal inference; residual confounding (e.g., medication use such as corticosteroids) cannot be excluded.
Clinicians managing OA should be aware that patients with a history of asthma or atopic dermatitis may face more severe structural disease and a higher likelihood of needing joint replacement. Atopic status may warrant closer radiographic monitoring and earlier discussion of surgical planning.
