Vitamin K antagonist anticoagulants increase the risk of osteoarthritis progression by inhibiting the vitamin K pathway.<\/p>\n
INTRODUCTION<\/strong> Vitamin K is important for healthy functioning of proteins in cartilage and bone, two major tissues in joints that are affected in osteoarthritis. For example, a protein called matrix Gla protein (MGP) depends on vitamin K to help prevent cartilage calcification.<\/p>\n Some people may need to take anticoagulant drugs to reduce the chance of blood clots. For example, you VKAs limit the availability of vitamin K, and affect the proteins that depend on it, such as MGP. Warfarin and acenocoumarol are two common VKA medicines. In the Netherlands, warfarin is not available, so acenocoumarol is the main prescribed VKA.<\/p>\n WHAT DID THE AUTHORS HOPE TO FIND?<\/strong> WHO WAS STUDIED?<\/strong> HOW WAS THE STUDY CONDUCTED?<\/strong> WHAT WERE THE MAIN FINDINGS OF THE STUDY?<\/strong> ARE THESE FINDINGS NEW?<\/strong> An accompanying study by Ballal and colleagues compared people using VKA and non-vitamin K inhibiting WHAT ARE THE LIMITATIONS OF THE STUDY?<\/strong> WHAT DO THE AUTHORS PLAN ON DOING WITH THIS INFORMATION?<\/strong> WHAT DOES THIS MEAN FOR ME?<\/strong> The results also suggest vitamin K supplementation might be helpful in people with osteoarthritis. This is yet to be investigated in clinical trials, but you could try including foods with more vitamin K as part of a healthy diet. For example, green leafy vegetables such as broccoli or spinach, or fruits as kiwifruit, blueberry, rhubarb, and cereal grains.<\/p>\n FURTHER READING<\/strong> Disclaimer:<\/strong> This is a summary of a scientific article written by a medical professional (\u201cthe Original Article\u201d). The Summary is written to assist non medically trained readers to understand general points of the Original Article. It is supplied \u201cas is\u201d without any warranty. You should note that the Original Article (and Summary) may not be fully relevant nor accurate as medical science is constantly changing and errors can occur. It is therefore very important that readers not rely on the content in the Summary and consult their medical professionals for all aspects of their health care and only rely on the Summary if directed to do so by their medical professional. Date prepared:<\/strong> April 2021 Copyright \u00a9<\/b>\u00a02021 BMJ Publishing Group Ltd & European League Against Rheumatism. Medical professionals may print copies for their and their patients and students non commercial use. Other individuals may print a single copy for their personal, non commercial use. For other uses please contact our\u00a0Rights and Licensing Team<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":" Vitamin K antagonist anticoagulants increase the risk of osteoarthritis progression by inhibiting the vitamin K pathway. INTRODUCTION Osteoarthritis is a common condition that makes a person\u2019s joints stiff and painful, particularly in the morning. It is caused by damage and destruction of the cartilage within the joints, which allows the bones to rub against each […]<\/p>\n
\nOsteoarthritis is a common condition that makes a person\u2019s joints stiff and painful, particularly in the morning. It is caused by damage and destruction of the cartilage within the joints, which allows the bones to rub against each other. Joint swelling and pain are frequent symptoms. It is the most common of all the different types of arthritis, and typically becomes more common as people get older.<\/p>\n
\nmay be prescribed an anticoagulant if you have a heart condition called atrial fibrillation. Some anticoagulant medicines work by blocking vitamin K. These are called vitamin K antagonist anticoagulants \u2013 VKA for short.<\/p>\n
\nThe authors wanted to find out whether taking a VKA increases the risk of osteoarthritis developing or worsening. If it does, this would add extra evidence that vitamin K is involved in osteoarthritis.<\/p>\n
\nThis study looked at over 3400 people who were taking part in a large population-based study in the Netherlands. The Rotterdam study examines thousands of people every 5 years to measure aspects of ageing, including osteoarthritis and medication use.<\/p>\n
\nThe Rotterdam Study is a prospective longitudinal study. The people taking part are observed over a period of time and measurements taken, but there is no study intervention or medicine being tested.
\nThe authors used some of the information collected to see if people taking the VKA acenocoumarol had an
\nincreased risk of osteoarthritis developing or worsening.<\/p>\n
\nThe main finding was that people taking acenocoumarol were twice as likely to develop osteoarthritis, or have progression of existing osteoarthritis. The risk of progression was four-times higher for people who had a variant in the gene coding for the MGP protein. This adds to the evidence that there is an association between vitamin K and osteoarthritis.<\/p>\n
\nYes. This is the first study to show that inhibition of vitamin K with acenocoumarol is associated with increased development and progression of osteoarthritis.<\/p>\n
\nanti-coagulants, and they also saw an increased risk for osteoarthritis in people taking VKAs.<\/p>\n
\nOne limitation is that everyone taking acenocoumarol did so because they had an underlying health condition. It is therefore possible that the effect seen on osteoarthritis is due to the underlying condition, not the VKA use. However, in the accompanying study this bias was examined, and the authors demonstrated that the effect could not be due to confounding by indication. In addition, the genetic finding indicates that there is a real causal relationship between vitamin K and osteoarthritis.<\/p>\n
\nThe authors want to investigate vitamin K supplementation as a possible treatment for osteoarthritis. They also plan to investigate the role of other proteins that depend on vitamin K.<\/p>\n
\nIf you have osteoarthritis \u2013 or are at high risk of developing osteoarthritis \u2013 you should preferable not be treated with acenocoumarol if you need anticoagulation for another health condition. There are other types of anti-coagulant medicines that do not inhibit vitamin K. These are called new or direct oral anti-coagulants (shortened to NOAC\/DOAC). If you have been prescribed a VKA, it is very important that you do not stop taking it without medical advice. Talk to your doctor if you have any concerns about your disease or its treatment. Keep in mind that for some heath conditions you can not switch from VKA to NOAC\/DOAC.<\/p>\n
\nBallal P, et al<\/em>. Warfarin use and risk of knee and hip replacements. Ann Rheum Dis 2021;80:605\u20139. doi:10.1136\/annrheumdis-2020-219646<\/p>\n
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\nSummary based on research article published on:<\/strong> 12 April 2021
\nFrom:<\/strong> Boer CG, et al. Vitamin K antagonist anticoagulant usage is associated with increased incidence and progression of osteoarthritis. Ann Rheum Dis 2021;80:598\u2013604. doi:10.1136\/annrheumdis-2020-219483<\/p>\n