Weiya Zhang

University of Nottingham | Notts · Division of Academic Rheumatology

Objective The main objective of this study is to examine the safety of oral acetaminophen at its therapeutic dose in adults aged ≥65 years. Methods This population‐based cohort study used the Clinical Practice Research Datalink‐Gold data. Participants were aged ≥65 years registered with a UK general practice for at least 12 months between 1998 and...

Background Synovitis has long been considered a common and modifiable inflammatory feature of osteoarthritis (OA), but current disease-modifying anti-inflammatory treatments appear ineffective in OA clinical trials. Elucidating the temporal relationship between synovitis and OA could provide insight into the role of synovitis in OA. Methods We con...

Background Associations of osteoarthritis (OA) with different comorbidities have gained attention recently. However, there is no literature on the congruency across different large primary care settings. Objectives We examined the associations of OA with 61 different comorbidities diagnosed before and after the first diagnosis of OA in four differ...

Background Professional football is a risk factor for knee OA, but it is unclear whether it is also a risk factor for foot/ankle OA. Objectives To compare the prevalence of foot/ankle outcomes (pain, GP-diagnosed OA, radiographic OA (ROA), and surgery) between male retired professional footballers and general population control men. Methods A pos...

Background Chronic shoulder pain (CSP) is a common musculoskeletal condition that can lead to sleeping difficulties, work disability and functional limitations in daily activities [1,2]. There is a gap in the evidence on the current prevalence and incidence of CSP in the UK, any variation that may exist between regions, and whether the occurrence o...

Objective Although hand synovitis is prevalent in the older population, the etiology remains unclear. Hyperuricemia, a modifiable metabolic disorder, may serve as an underlying mechanism of hand synovitis, but little is known about their relationship. We assessed the association between hyperuricemia and hand synovitis in a large population‐based s...

Objectives Knee synovial abnormalities, potentially treatment targets for knee pain and osteoarthritis, are common in middle-aged and older population, but its etiology remains unclear. We examined the associations between hyperuricemia and knee synovial abnormalities detected by ultrasound in a general population sample. Methods Participants aged...

Objectives Early-onset osteoarthritis (OA) is an emerging health issue amidst the escalating prevalence of overweight and obesity. However, there are scant data on its disease, economic burden and attributable burden due to high body mass index (BMI). Methods Using data from the Global Burden of Diseases Study 2019, we examined the numbers of inci...

Melatonin exhibits potential for pain relief and long‐term safety profile. We examined the analgesic effects of oral melatonin on osteoarthritis (OA) and investigated the underlying mechanism. Using data from a UK primary care database, we conducted a cohort study in individuals with OA to compare the number of oral analgesic prescriptions and the...

Our aim was to investigate relative contributions of central and peripheral mechanisms to knee osteoarthritis (OA) diagnosis and their independent causal association with knee OA. We performed longitudinal analysis using data from UK-Biobank participants. Knee OA was defined using International Classification of Diseases manual 10 codes from partic...

Objectives The incidence of gout in the UK appears to have declined since 2013; however, whether such a trend occurred across participants born in different years (ie, birth cohort) is unknown. We aimed to examine the effects of the birth cohort on gout incidence using an age-period-cohort (APC) model. Design Cross-sectional study. Setting Nation...

Objective The pathogenesis of hand osteoarthritis (OA) remains unknown. Hyperuricaemia, which is related to inflammation, may play a role in hand OA, but evidence is lacking. In a large population-based study, we examined the association between hyperuricaemia and hand OA. Methods Participants were from the Xiangya OA Study, a community-based obse...

Objectives Knee synovitis is a highly prevalent and potentially curable condition for knee pain; however, its pathogenesis remains unclear. We sought to assess the associations of the gut fungal microbiota and the fungi–bacteria correlation network with knee synovitis. Methods Participants were derived from a community-based cross-sectional study....

Background Since gut microbiome dysbiosis can cause inflammatory disorders by affecting host metabolism, we postulate that the gut microbiome and related metabolites could play a role in hand osteoarthritis. We characterised gut microbiome-related metabolites in people with symptomatic hand osteoarthritis (SHOA) in two independent cohorts. Methods...

Hand osteoarthritis is a common heterogeneous joint disorder with unclear molecular mechanisms and no disease-modifying drugs. In this study, we performed single-cell RNA sequencing analysis to compare the cellular composition and subpopulation-specific gene expression between cartilage with macroscopically confirmed osteoarthritis (n = 5) and cart...

Background: There is paucity of safe and effective analgesic drugs for osteoarthritis (OA). β-adrenoreceptor blockers have demonstrated anti-nociceptive effects in several painful conditions. We investigated whether β-blockers are associated with a reduced risk of total joint replacement (TJR) at the knee or the hip in people with incident knee or...

Objective: To investigate the causal association between Osteoarthritis (OA) and five comorbidities: depression, tiredness, multisite chronic pain, irritable bowel syndrome (IBS) and gout. Design: This study used two-sample Mendelian Randomisation (MR). To select the OA genetic instruments, we used data from the largest recent genome-wide associati...

Knee pain is associated with lower muscle strength, and both contribute to disability. Peripheral and central neurological mechanisms contribute to OA pain. Understanding the relative contributions of pain mechanisms to muscle strength might help future treatments. The Knee Pain and related health In the Community (KPIC) cohort provided baseline an...

Background Comorbidities are common in patients with osteoarthritis (OA). This study aimed to determine the association of a wide range of previously diagnosed comorbidities in adults with newly diagnosed OA compared with matched controls without OA. Methods A case–control study was conducted. The data were derived from an electronic health record...

Importance: Although professional soccer players appear to be at higher risk of neurodegenerative disease, the reason remains unknown. Objective: To examine whether heading frequency is associated with risk of cognitive impairment in retired professional soccer players. Design, setting, and participants: A UK nationwide cross-sectional study w...

Aim: To identify constitutional morphological features at the knee that associate with knee osteoarthritis (OA, KOA). Methods: This was a case-control study using data from the Genetics of Osteoarthritis and Lifestyle (GOAL) study. Radiographic measurements at the knee were undertaken by a single trained observer. Measurement of 12 characteristics...

Background Previous studies based on death certificates have found professional soccer players were more likely to die with neurodegenerative diseases, including dementia. Therefore, this study aimed to investigate whether retired professional male soccer players would perform worse on cognitive tests and be more likely to self-report dementia diag...

Background: The burden of osteoarthritis (OA) in UK primary care has not been investigated thoroughly. Aim: To estimate healthcare use and mortality in people with OA (overall and joint specific). Design and setting: A matched cohort study of adults with an incident diagnosis of OA in primary care were selected for the study using UK national...

Objective: Synovial abnormalities are modifiable targets for hand pain and osteoarthritis. We examined the prevalence and distribution of ultrasound-detected hand synovial abnormalities in a community-derived sample of older people in China. Methods: Within a community-based study, we assessed synovial hypertrophy (SH), joint effusion, and Power...

Abstract Background Both BNT162b2 (Pfizer–BioNTech) and ChAdOx1 nCoV-19 (Oxford–AstraZeneca) vaccines have shown high efficacy against COVID-19 in randomized controlled trials. However, their comparative effectiveness against COVID-19 is unclear in the real world. We evaluated the comparative effectiveness of the BNT162b2 and ChAdOx1 nCoV-19 vaccin...

Objectives: Guidelines recommend knee osteoarthritis pain management based on biopsychosocial mechanisms. Treatment adherence and effectiveness may be affected if there is a mismatch between patient perspectives and treatment focus. We therefore examined patient perspectives on mechanisms of their knee pain, why it persisted or changed over the pa...

Osteoarthritis (OA) is the most common arthritis affecting synovial joints such as knees and hips of millions of people globally. Usage-related joint pain and reduced function are the most common symptoms experienced by people with OA. To improve pain management, there is a need to identify validated biomarkers predicting therapeutic responses in t...

Objectives: To explore clustering of comorbidities among patients with a new diagnosis of osteoarthritis (OA) and estimate the 10-year mortality risk for each identified cluster. Methods: This is a population-based cohort study of individuals with first incident diagnosis of OA of the hip, knee, ankle/foot, wrist/hand, or 'unspecified' site betw...

Objective Clinical guidelines recommend exercise as a core treatment for knee or hip osteoarthritis (OA). However, how its analgesic effect compares to analgesics, for example, oral non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol—the most commonly used analgesics for OA, remains unknown. Design Network meta-analysis. Data sources P...

The reciprocal interaction between pain and negative affect is acknowledged but pain‐related alterations in brain circuits involved in this interaction, such as the mediodorsal thalamus (MDThal), still require a better understanding. We sought to investigate the relationship between MDThal circuitry, negative affect and pain severity in chronic mus...

Objective To determine the risk of comorbidity following diagnosis of knee or hip osteoarthritis (OA). Design A cohort study was conducted using the Integrated Primary Care Information database, containing electronic health records of 2.5 million patients from the Netherlands. Adults at risk for OA were included. Diagnosis of knee or hip OA (=expo...

Objectives Observational studies have demonstrated associations between gout and hypertension, but whether they are causal remains unclear. Our work aims to assess the causal relationship between gout and hypertension. Methods We obtained genetic information from the Taiwan Biobank, including 88,347 participants and 686,439 single-nucleotide polym...

Objective The aim was to test the feasibility of a randomized controlled trial exploring whether omega-3 fatty acid supplementation limits gout flares during treat-to-target urate-lowering treatment (T2T-ULT). Methods Adults with at least one gout flare in the past 12 months and serum urate (SU) ≥360 μmol/l were recruited from general practices (p...

Objectives To explore clustering of comorbidities among patients with a new diagnosis of osteoarthritis (OA) and estimate the 10-year mortality risk for each identified cluster. Methods This is a population-based cohort study of individuals with first incident diagnosis of OA of the hip, knee, ankle/foot, wrist/hand, or unspecified site between 200...

Objectives To develop evidence-based expert recommendations for non-pharmacological treatments for pain, fatigue, sleep problems, and depression in fibromyalgia. Methods An international, multidisciplinary Delphi exercise was conducted. Authors of EULAR and the Canadian Fibromyalgia Guidelines Group, members of the American Pain Society and clinic...

Objective To estimate the risk of developing comorbidities in patients after physician‐diagnosed knee or hip osteoarthritis (OA). Methods This was a cohort study using Swedish longitudinal health care register data; we studied residents in the Skåne region age ≥35 years on January 1, 2010 who were free from diagnosed hip or knee OA (n = 548,681)....

Objectives: The aims were to examine the prevalence of comorbidities and role of oral analgesic use in people with knee pain (KP) compared with those without. Methods: The Knee Pain and related health In the Community (KPIC) cohort comprises community-derived adults aged ≥40 years, irrespective of knee pain. Thirty-six comorbidities across 10 sy...

Background: Osteoarthritis (OA) is a common and disabling disease that places a significant burden on both patients and health care systems. Previous studies have already shown that patients with OA have a higher risk of developing comorbidities. However, many focused on one or a few conditions only, or did not consider the chronology of the diseas...

Background: Osteoarthritis (OA) patients are more likely to have other comorbidities (Swain, Sarmanova et al. 2020). Improving the understanding of comorbidity profiles of OA patients may lead to improvement in their clinical care. Objectives: To identify sub-groups in patients diagnosed with hip OA using patterns of comorbidity. Methods: Routinely...

Background: People with osteoarthritis (OA) are at higher risk of developing a wide array of comorbidities. Whether the use of non-steroidal anti-inflammatory drugs (NSAIDs) contributes to the increased risk of some incident comorbidities remains unknown. Objectives: To examine the contribution of NSAIDs in the development of a wide range of comorb...

Background Emerging evidence suggests that dysbiosis in gut microbiota may contribute to the occurrence or development of several rheumatic diseases. Since gut microbiota dysbiosis is potentially modifiable, it has been postulated to be a promising preventive or therapeutic target for rheumatic diseases. However, the current understanding on the po...

Background Contextual factors (CFs) related to the patient, healthcare practitioners, and their therapeutic relationship are integral to the overall treatment effect of any given intervention (1). In osteoarthritis (OA), around 75% of the treatment effect is directly attributable to CFs (2). Identifying and understanding the role of CFs may encoura...

Aim To study the risk of receiving a new (incident) osteoarthritis (OA) diagnosis in different joint sites based on conditions diagnosed in the 20 years prior the OA diagnosis. Methods We used register data for the entire population of the Skåne region (Sweden) to perform a nested case-control study. The outcome was newly diagnosed (incident) OA i...

Objectives Observational studies have demonstrated associations between gout and hypertension, but whether they are causal remains unclear. Our work aims to determine the causal relationship between gout and hypertension. Methods We obtained genetic information from the Taiwan Biobank including 88347 participants and 686439 single nucleotide polymo...

Introduction Osteoarthritis (OA) is one of the leading chronic conditions in the older population. People with OA are more likely to have one or more other chronic conditions than those without. However, the temporal associations, clusters of the comorbidities, role of analgesics and the causality and variation between populations are yet to be in...

Introduction Professional footballers commonly experience sports-related injury and repetitive microtrauma to the foot and ankle, placing them at risk of subsequent chronic pain and osteoarthritis (OA) of the foot and ankle. Similarly, repeated heading of the ball, head/neck injuries and concussion have been implicated in later development of neuro...

Objective Chronic pain due to osteoarthritis (OA) is a major clinical problem, and existing analgesics often have limited beneficial effects and/or adverse effects, necessitating the development of novel therapies. Epoxyeicosatrienoic acids (EETs) are endogenous antiinflammatory mediators, rapidly metabolized by soluble epoxide hydrolase (EH) to di...

Objectives To investigate the role of osteoarthritis (OA) in the incidence of musculoskeletal, metabolic, cardiovascular, digestive, neuro-psychological, kidney and other comorbidities/adverse events after (i) incident non-steroidal anti-inflammatory drug (NSAID) initiation and (ii) NSAID discontinuation. Methods We used register data for the popu...

Objective To examine the clusters of chronic conditions present in people with osteoarthritis and the associated risk factors and health outcomes. Methods Clinical Practice Research Datalink (CPRD) GOLD was used to identify people diagnosed with incident osteoarthritis (n=221807) between 1997-2017 and age (+2 years), gender, and practice matched c...

Background Neuropathic pain symptoms and signs of increased pain sensitisation in osteoarthritis (OA) patients may explain persistent pain after total joint replacement (TJR). Therefore, identifying genetic markers associated with pain sensitisation and neuropathic-like pain phenotypes could be clinically important in identifying targets for early...

Background Use of serum urate as a treatment target and outcome measure has become controversial in view of the 2017 American College of Physicians guidelines, which advocated a treat-to-symptom rather than a treat-to-target serum urate approach to gout management. The relevance of serum urate as a treatment target measure implies that achievement...

Objective To develop and validate a prognostic model for leflunomide discontinuation with abnormal blood-test results. Methods Data from CPRD Gold and Aurum were used for model development and external validation respectively. Participants prescribed leflunomide between 01/01/2007 and 31/12/2019 were followed-up from six-months after first GP-pres...

Background: Knee pain is a major source of distress and disability, with pain progression highly variable between individuals. Previous studies defining pain trajectories have all used a single measure of pain, and these differ across studies. Different measures reflect diverse pain mechanisms. To ascertain the clinical utility of pain trajectorie...

Fibromyalgia is a highly heterogeneous condition, but the most common symptoms are widespread pain, fatigue, poor sleep, and low mood. Non-pharmacological interventions are recommended as first-line treatment of fibromyalgia. However which interventions are effective for the different symptoms is not well understood. The objective of this study was...

Introduction: Symptomatic treatments for osteoarthritis (OA) provide only small-to-moderate efficacy over placebo in randomised controlled trials (RCTs). Treatment guidelines therefore have emphasised the need to identify predictors of treatment response through subgroup and multiple regression analysis. Individual participant data (IPD) meta-anal...

Objective Systemic inflammatory factors have been implicated in symptomatic hand osteoarthritis (OA). Gut microbiome dysbiosis promotes systemic inflammation. The aim of this study was to examine the association between the gut microbiome and the presence of symptomatic hand OA in a population‐based study. Methods Study participants were subjects...

Objectives To examine the association between β-blocker prescription and knee or hip total joint replacement (TJR) in a UK primary-care population with incident knee or hip osteoarthritis (OA). Methods Cohort study using data from the Clinical Practice Research Datalink. Participants aged ≥40 years with incident knee or hip OA, exposed to β-blocker...

Objectives: To systematically review the literature on inter- and intra-rater reliability of scoring ultrasound and MRI changes in hand osteoarthritis (OA). Methods: Medline, EMBASE, CINHAL, Web of Science and AMED were searched from inception to January 2020. Kappa (K), weighted Kappa (Kw) and intra-class correlation coefficients (ICC) for dich...

Abstract Background There is paucity of data on the prevalence of ultrasound-detected synovial abnormalities in the general population, and the relationship between synovial changes and knee pain remains unclear. We examined the prevalence of synovial abnormalities on ultrasound and the relationship of these features with knee pain and radiographic...

Background Placebo or contextual effect is an integral part of the treatment effect (1). The factors related to this effect are “contextual factors” (CFs) (2). CFs may be categorised into five groups as factors related to practitioner, patient, practitioner-patient interaction, treatment and therapeutic environment (3). Several CFs have demonstrate...

Objective Current global guidelines regarding the first-line analgesics (acetaminophen, topical or oral non-steroidal anti-inflammatory drugs [NSAIDs]) for knee osteoarthritis remain controversial and their comparative risk-benefit profiles have yet to be adequately assessed. Design Pubmed, Embase, Cochrane Library, and Web of Science were searche...