Reduction in Osteoarthritis Risk After Treatment With Ticagrelor Compared to Clopidogrel: A Propensity Score-Matching...

Area of Science:

• Rheumatology
• Pharmacology
• Cardiology

Background:

• Osteoarthritis (OA) is a prevalent cause of joint pain and disability with limited effective treatments.
• Extracellular adenosine exhibits anti-inflammatory properties and has shown potential in preventing and treating OA in preclinical models.
• Ticagrelor, unlike clopidogrel, is known to increase extracellular adenosine levels, suggesting a potential therapeutic role in OA.

Purpose of the Study:

• To investigate the association between ticagrelor treatment and the risk of developing osteoarthritis (OA).
• To compare the incidence of OA diagnosis in patients receiving ticagrelor versus clopidogrel.

Main Methods:

• A 1:2 propensity score-matched analysis was conducted using data from 2011-2017.
• Patients treated with ticagrelor or clopidogrel for at least 90 days, without prior OA or inflammatory arthritis, were included.
• The primary outcome was the time to OA diagnosis, identified via International Classification of Diseases codes.

Main Results:

• The study included 7,007 ticagrelor-treated patients and 14,014 clopidogrel-treated patients.
• Multivariate Cox regression analysis revealed a 29% lower risk of developing OA in the ticagrelor group (Hazard Ratio: 0.71; 95% CI: 0.64-0.79; P < 0.001).
• The median treatment duration was similar between groups (287 days for ticagrelor, 284 days for clopidogrel).

Conclusions:

• Ticagrelor treatment is associated with a significantly reduced risk of developing osteoarthritis compared to clopidogrel.
• The observed protective effect of ticagrelor against OA may be partly attributed to its ability to increase extracellular adenosine levels.
• These findings suggest a potential novel therapeutic application for ticagrelor in the management or prevention of osteoarthritis.