Osteoarthritis less likely to occur in ticagrelor- vs clopidogrel-treated patients

Ticagrelor appears to reduce the risk of developing osteoarthritis (OA) more than clopidogrel, with the OA-free survival advantage persisting through 5 years of follow-up, according to a study.

The study used data from 119,947 patients with no known diagnosis of OA, inflammatory arthritis, or prior arthroplasty. Of these, 7,007 patients were treated with ticagrelor and 112,940 patients received clopidogrel, with both treatment lasting at least 90 days. Those on ticagrelor were younger (mean age, 63.8 vs 69.2 years), more likely to be male (72.9 percent vs 61.8 percent), had a lower Charlson comorbidity score (score of 0: 48.7 percent vs 39.9 percent) and fewer days of treatment (median duration, 287 vs 392 days), among others.

After propensity score matching, 7,007 patients on ticagrelor and 14,014 on clopidogrel were included in the final analysis. The median of days receiving treatment was 287 and 284, respectively. Their mean age was 64 years, and 73 percent of the patients were male.

OA occurred less frequently with ticagrelor, with an incidence rate of 62.8 per 1,000 person–years relative to 89.2 per 1,000 person–years with clopidogrel. Multivariate Cox regression analysis confirmed this association (hazard ratio [HR], 0.71, 95 percent confidence interval [CI], 0.64–0.79; p<0.001).

Furthermore, ticagrelor yielded benefits for all OA subtypes, with a greater reduction in the risks of OA of the hands (HR, 0.71, 95 percent CI, 0.53–0.96; p=0.025) and knees (HR, 0.769, 95 percent CI, 0.58–0.83; p<0.001) but not the hips (HR, 0.72, 95 percent CI, 0.34–1.53; p=0.394).

The findings highlight the potential of ticagrelor in reducing OA incidence by producing an increase in extracellular adenosine—an effect not seen with clopidogrel.