Impact of comorbidities in patients with erosive hand osteoarthritis (EHOA), a monocentric study

Objective: Erosive hand osteoarthritis (EHOA) is a severe and rapidly progressing form of osteoarthritis that has been linked to systemic comorbidities (i.e., metabolic bone and cardiovascular diseases). The object of this study is to retrospectively evaluate the impact of comorbidities (i.e., osteoporosis, diabetes and overweight) on the clinical course and radiographic findings in a cohort of EHOA patients. Design: This is a retrospective cross-sectional study. Patients underwent clinical assessments and completed the VAS scale, the AUSCAN and DREISER questionnaires. Metabolic, cardiovascular, and bone health data were collected. Radiographic features-osteophytes, joint space narrowing, malalignment, erosions, sclerosis, and subchondral cysts-were evaluated using the Altman system. Comorbidities were assessed using the Charlson Comorbidity Index, whereas metabolic syndrome, diabetes, and osteoporosis were defined according to the ATP III and WHO criteria. Statistical analysis was conducted via Spearman's correlation, using GraphPad Prism 9.1.0, with significance set at p < 0.05. Results: Eighty-seven patients (88.5% female, mean age 63.17 ± 8.85) were included. Among comorbidities, 76.8% had at least one risk factor; BMI correlated with joint space narrowing (r = 0.22, p = 0.04). Severity of femoral and lumbar osteoporosis correlated with AUSCAN and DREISER scores; FRAX scores significantly correlated with several radiographic features of EHOA; VAS correlated with swollen and painful joint count, with AUSCAN and DREISER scores and with osteophytosis. Disease duration correlated with overall radiographic damage. Conclusion: Cardiovascular and metabolic bone comorbidities, especially overweight and osteoporosis, appear to be associated with higher pain burden, functional impairment, and greater structural damage in EHOA patients.