Data Trends 2022: Rheumatologic Diseases
Arthritis, and in particular posttraumatic osteoarthritis (PTOA), is more common in the veteran population compared with civilians, largely due to the physical toll of active-duty service.1,2 Certain exposure-related factors have been linked to an increased risk of rheumatoid arthritis, while the burdens of health care costs and comorbidities have been proven to be elevated in veterans with psoriatic arthritis.3,4
Who is affected by arthritis? Veterans vs civilians1
A 2021 study of 3 million veterans looked at the link between frailty and risk of cardiovascular death. Within this population, a stable but higher prevalence of arthritis was found along with a small trend upwards in related comorbidities. Frailty was defined based on a 31-item index assessing physical function, comorbidities, sensory loss, cognition, and mood.6
A survey of patients in the Veterans Association Rheumatoid Arthritis Registry sought to determine whether there was any association between inhalant exposures, rheumatoid arthritis (RA)-related autoantibodies, and disease severity. Exposure to military burn pits and military waste disposal were each associated with higher odds of anti-cyclic citrullinated peptide (anti-CCP) antibodies compared with other inhalant exposures.3
For patients with moderate-to-severe psoriasis (PsO) or psoriatic arthritis (PsA), the likelihood of significant comorbidity diagnoses—such as cancer, diabetes, and liver disease—exists.11
Arthritis help for veterans. Centers for Disease Control and Prevention. Updated November 10, 2020. Accessed March 20, 2022. https://www.cdc.gov/arthritis/communications/features/arthritis-among-veterans.html
Cameron KL, Hsiao MS, Owens BD, Burks R, Svoboda SJ. Incidence of physician-diagnosed osteoarthritis among active duty United States military service members. Arthritis Rheum. 2011;63(10):2974-2982. http://doi.org/10.1002/art.30498
Ebel AV, Lutt G, Poole JA, et al. Association of agricultural, occupational, and military inhalants with autoantibodies and disease features in US veterans with rheumatoid arthritis. Arthritis Rheumatol. 2021;73(3):392-400. http://doi.org/10.1002/art.41559
Lee S, Xie L, Wang Y, Vaidya N, Baser O. Comorbidity and economic burden among moderate-to-severe psoriasis and/or psoriatic arthritis patients in the US Department of Defense population. J Med Econ. 2018;21(6):564-570. http://doi.org/10.1080/13696998.2018.1431921
Fish L, Scharre P. The soldier's heavy load. Center for a New American Security. Published September 26, 2018. Accessed April 27, 2022. https://www.cnas.org/publications/reports/the-soldiers-heavy-load-1
Shrauner W, Lord EM, Nguyen XMT, et al. Frailty and cardiovascular mortality in more than 3 million US veterans. Eur Heart J. 2022;43(8):818-826. http://doi.org/10.1093/eurheartj/ehab850
Tyrer J. Military service leads to post-traumatic osteoarthritis. Published April 2021. Accessed March 25, 2022. https://www.arthritis.org/diseases/more-about/military-service-leads-to-post-traumatic-osteoarth
Cameron KL, Shing TL, Kardouni JR. The incidence of post-traumatic osteoarthritis in the knee in active duty military personnel compared to estimates in the general population. Presented at the Osteoarthritis Research Society International World Congress on Osteoarthritis, April 27-30, 2017, Las Vegas, NV.
Rivera JD, Wenke JC, Buckwalter JA, Ficke JR, Johnson AE. Posttraumatic osteoarthritis caused by battlefield injuries: The primary source of disability in warriors. J Am Acad Orthop Surg. 2012;20(01):S64-S69. http://doi.org/10.5435/JAAOS-20-08-S64
Patzkowski JC, Rivera JC, FIcke JR, Wenke JC. The changing face of disability in the US Army: The Operation Enduring Freedom and Operation Iraqi Freedom Effect. J Am Acad Orthop Surg. 2012; 20(S1): S23-S30. http://doi.org/10.5435/JAAOS-20-08-S23
Related conditions of psoriasis. National Psoriasis Foundation. Updated October 8, 2020. Accessed March 25, 2022. https://www.psoriasis.org/related-conditions/
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