Vitamin K antagonist anticoagulant usage is associated with increased incidence and progression of osteoarthritis

Boer CG, Szilagyi I, Nguyen NL, et al. · Annals of the Rheumatic Diseases

The strongest human evidence that vitamin K function matters to cartilage, obtained by blocking it: acenocoumarol users had 2.50 times the risk of osteoarthritis incidence and progression (95% CI 1.94-3.20), 2.34 for knee and 2.74 for hip. Users carrying both the high-VKORC1-expression haplotype and the MGP risk allele reached 4.18 (2.69-6.50), while the same genotype carried no risk in non-users.

Population

Rotterdam Study participants with radiographic knee and hip follow-up

Intervention

Use of the vitamin K antagonist acenocoumarol; MGP and VKORC1 genotypes examined

Comparator

Non-users

Limitations

Observational: people prescribed anticoagulants differ from those who are not in cardiovascular disease, activity and body weight, and confounding by indication cannot be ruled out. It tests blocking vitamin K, not supplementing it.