Family History of Arthritis Increases Risk for Multiple Rheumatological Conditions

Danielle Rasooly, PhD

Credit: Harvard Medical School

Family history of rheumatological conditions were associated with increased risk for the same condition as well as other rheumatological conditions, according to new research published in Arthritis Care and Research.¹

“The aim was to estimate odds ratios of associations between family history of arthritis, osteoporosis, and carpal tunnel syndrome (CTS) and prevalence in a real-world population, uncovering family histories of related conditions that may increase risk due to shared heritability, condition pathophysiology, or social/environmental factors,” lead investigator Danielle Rasooly, PhD, Centers for Disease Control and Prevention, Atlanta, Georgia, and colleagues wrote.¹

Rasooly and colleagues analyzed data from 156,307 participants in the All of Us research program and looked at associations between the prevalence offibromyalgia, gout, osteoarthritis (OA), rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), osteoporosis, and CTS and self-reported first-degree family history. They also looked at associations across these conditions and performed stratified analyses by race and ethnicity, sex, socioeconomic differences, body mass index, and type of affected relative.¹

The investigators found that over 38% of participants reported a family history of arthritis (including fibromyalgia, gout, OA, RA, and SLE), osteoporosis, or CTS. Adults with a family history of these conditions had an average 4.90 odds ratio (odds ratio [OR]; range, 3.68-7.59) of having the same condition and an average 1.24 OR (range, 0.70-2.10) of having a different condition. The strongest association was between family history of OA and prevalence of OA (OR, 7.59 [95%CI, 7.32-7.88]), and family history of SLE and prevalence of SLE (OR, 6.34 [95%CI, 5.17-7.74]).¹

“Family history of several related conditions was associated with increased risk for arthritis, osteoporosis, and CTS, underscoring the importance of family history of related conditions for primary prevention,” Rasooly and colleagues wrote.¹

Other recent research looking into associations between rheumatological diseases found that having OA, even without hand/wrist presentation, increased the risk of having CTS in Untied States patients in the Optum claims database aged at least 45 years and diagnosed with OA between January 1, 2018, and December 31, 2022.²

After propensity-score matching, the OA and non-OA cohorts each included 1,033,439 individuals. CTS had an incidence rate of 7.25 per 1000 person years (PY; 95% CI [7.21-7.49]) in the OA cohort and 1.44/1000 PY (95% CI, 1.38-1.50) in the non-OA cohort. Patients across all OA types had around a 4-fold greater risk of developing CTS than those without OA (hazard ratio, 3.80 [95% CI, 3.54-4.07]). Patients with OA of the hand/wrist had the highest risk for CTS (HR, 8.86 [95% CI, 8.08–9.73]), while knee OA was associated with the lowest risk (HR, 2.67 [95% CI, 2.45–2.89]). Patients with multiple affected joints on the index date had a higher incidence rate of CTS compared with those with only one affected joint.²

“This is the first population-based cohort study in the US to provide incidence rates of CTS in adults with OA, and to examine the risk of OA by affected joints. Our study not only reports that OA increases the risk of CTS, but also suggests that this risk is not limited to patients with hand or wrist OA, suggesting a systemic impact of OA on CTS. While riskappears to be highest for patients with affected hand or wrist joints, those with more distant affected joints like the knee or hip also have an increased risk. Results are also suggestive of an increased risk among patients with an increasing number of affected joints,” investigators wrote.²

REFERENCES

1. Rasooly D, Moonesinghe R, Fallon E, Barbour KE, Khoury MJ. Family history of arthritis, osteoporosis, and carpal tunnelsyndrome and risk of these conditions among U.S. adults. Arthritis Care Res. Published online August 19, 2024. doi: 10.1002/acr.25416
2. Chen S, Ho T, Asubonteng J, et al. Risk of carpal tunnelsyndrome among patients with osteoarthritis: a US population-based study. BMC Musculoskelet Disord. 2024;25(1):468. Published 2024 Jun 15. doi:10.1186/s12891-024-07459-1