Osteoarthritis is the most common form of all arthritis, affecting 20% of people over the age of 50 globally.
In Malaysia, research has uncovered key insights into the disease, as revealed by Prof Tan Maw Pin, a professor in geriatric medicine from Universiti Malaya who also serves as adjunct professor at Sunway University.
While research shows various main factors leading to disability from osteoarthritis including being overweight or obese, and joint cartilage degeneration or wear and tear, Prof Tan added that there is evidence to show correlation between osteoarthritis with lifestyle choices.
“Our main struggle is getting patients to understand arthritis is not part of old age; treatment needs to be sought out early because a lot of our patients are presenting at the end stage,” she said.
Prof Tan stressed that much can be done for the “prevention of deterioration and [we can] prevent the need for surgical intervention,” when more robust research becomes available. “Joint replacement surgery is expensive and not affordable (for everyone).”
Even when patients can afford the surgery, they often decline, Prof Tan relates, because of the fear of surgery at an advanced age. If a patient goes to their GP to complain of pain in the knee, they may receive an anti-inflammatory drug to manage it, or, they may be told “it’s just old age”.
“Osteoarthritis is not a normal process of ageing,” she emphasised. According to a UM study, about 20% of those aged 18 and above suffer knee pain, says Prof Tan. Malaysians need to think about prevention before they reach their 50s.
“By 2035, 15% of the Malaysian population will be aged over 65,” Prof Tan points out. “Osteoarthritis is not a harmless disease and as a nation, we can’t afford to have people leave the workforce to care for senior sufferers.”
Studies have shown that one in three Malaysians over the age of 55 suffers osteoarthritic pain.
“Patients need to understand that they can treat their condition in combination – invest in medically-certified treatment early, such as taking supplements that are backed by clinically proven studies or obtaining supportive help from sources such as stabilised crystalline glucosamine sulfate, and undertake a weight loss regime as obesity is a major risk factor for inflammation in the body and osteoarthritis.”
Prof Jean-Yves Reginster, a fellow researcher who has extensively researched stabilised crystalline glucosamine sulfate in relation to improvement for knee osteoarthritis, was on hand to share the latest treatment algorithm with healthcare professionals.
As the president of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO), Prof Reginster provided the current global picture of several aspects of the disease.
“Osteoarthritis is recognised as the 11th highest contributor of global disability when we talk about the lower limbs,” he said. “It is a highly-debilitating disease and more than 250 million people globally suffer from arthritis.”
Both professors Tan and Reginster stressed several points about osteoarthritis that may be misunderstood by the public, such as the misconception that osteoarthritis is a condition that occurs only with old age, or that it is not preventable and surgical intervention is the only solution.
When the progression of osteoarthritis is not properly treated, Prof Reginster cautioned, it can lead to surgery and joint replacement. Surgical intervention, as Prof Tan elaborates, is something that can be prevented.
Prof Reginster undertook a critical analysis of existing research literature from the past 15 years on guidelines for the treatment and prescription for osteoarthritis, and in 2014 revealed an algorithm built by ESCEO.
With more evidence and patient information available, the latest algorithm is said to help harmonise guidelines and prioritise safety and efficacy.
It is a crucial step in addressing the discrepancies and differences in guidelines and recommendations by physicians in the treatment of osteoarthritis worldwide by providing a more natural approach to the disease.
“We are not treating the average patient,” he explained. While physicians may prescribe a particular drug for the treatment of osteoarthritis, for instance, “the patient might be diabetic, they might be hypertensive,” and so, physicians may need to adapt, he said.