OP0228 USE OF NON-STEROIDAL ANTI-INFLAMMATORY DRUGS AND RISK OF COMORBIDITIES IN PEOPLE WITH AND WITHOUT OSTEOARTHRITIS - A UK PRIMARY CARE DATABASE COHORT STUDY

Background People with osteoarthritis (OA) are at higher risk of developing a wide array comorbidities. Whether the use non-steroidal anti-inflammatory drugs (NSAIDs) contributes to increased some incident comorbidities remains unknown. Objectives To examine contribution NSAIDs in development range people and without OA. Methods This observational cohort study used UK primary care Clinical Practice Research Datalink (CPRD) GOLD containing data on 20+ million covering 937 practices. We identified 259,000 OA age (±2 years), sex, practice matched controls 1:1 ratio. Controls were assigned same index date (the first diagnosis OA) as cases for start follow-up. Both further divided into two groups according NSAID prescriptions any time after date. allowed us both main effect each exposure interaction between an prescription before excluded from study. was defined least within 90 days. Exposure status participant assessed every six months yes/no until end study/outcome interests/death/last available, whichever came first. Comorbidities grouped 9 categories cancer, cardiovascular disease (CVD), endocrine, psychological, renal, gastrointestinal (GI), genitourinary, hepatic, neurological conditions. Propensity scores calculated using logistic regression model including age, body mass (BMI), musculoskeletal pain related conditions covariates. The propensity score adjusted varying analysis undertaken multivariate COX hazard ratio (HR) 95% confidence intervals calculated. Proportional assumption tested Schoenfeld test. Smoking, alcohol, ever proton pump inhibitors (PPIs) other included model. additional towards comorbidity estimated addictive methods. also investigated individual across non-selective, COX-2 selective NSAIDs. Results mean 59.4±12.8 years 60.2±12.8 57.7% being female. Nearly thirds prescribed defined, compared one third control population. exposed had highest psychological (1.51; 1.43,1.60), CVD (1.38; 1.33,1.43), cancer (1.34; 1.25,1.44), GI (1.25; 1.16,1.34) renal (1.17; 1.11,1.24) adjusting all covariates PPI drugs, non-OA non-NSAID group. (Figure 1) Interaction significant GI, outcomes. Within OA, non-selective 1.20,1.30), (1.11; 1.04,1.19), endocrine (1.15; 1.10,1.19), (1.19; 1.13,1.26) (1.21; 1.15,1.28) comorbidities, whereas (1.13; 1.04,1.21), 1.14,1.37), 1.09,1.34) Figure 1. Hazard different (reference group: no NSAIDs) OA- Osteoarthritis; NSAIDS- Non-steroidal drugs. Conclusion Use among is associated variety Non-selective cardiovascular, Acknowledgements thank Patient Participants (PRP) members Jenny Cockshull, Stevie Vanhegan, Irene Pitsillidou their involvement since beginning project. would like FOREUM financially supporting research. Disclosure Interests Subhashisa Swain: None declared, Anne Kamps: Jos Runhaar: Andrea Dell’Isola: Aleksandra Turkiewicz: Danielle E Robinson: Victoria Y Strauss: Christian Mallen: Chang-Fu Kuo: Carol Coupland: Michael Doherty Consultant of: Advisory borads gout Grunenthal Mallinckrodt, Grant/research support from: AstraZeneca funded Nottingham Sons Gout study, Aliya Sarmanova: Daniel Prieto-Alhambra Speakers bureau: paid speaker services Amgen UCB Biopharma., His department has received advisory or consultancy fees Amgen, Astellas, AstraZeneca, Johnson, Biopharma, Prof. Prieto-Alhambra’s research group grant Chesi-Taylor, Novartis, Martin Englund: S.M.A. Bierma-Zeinstra: Weiya Zhang Bioiberica invited EULAR 2016 satellite symposium, advice management,