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Relationship Amongst Vitamin K Status, Vitamin K Antagonist Use and Osteoarthritis: A Review

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Abstract

Vitamin K is essential for the carboxylation of the vitamin K-dependent proteins that are responsible for the suppression of matrix calcification. The use of vitamin K antagonists (VKAs) in patients with cardiovascular diseases could affect protein carboxylation and lead to the development of osteoarthritis (OA). This review aims to summarise the current evidence for the relationship between VKAs and OA. The literature search revealed that in observation studies, good vitamin K status, as reflected by the circulating level or protein carboxylation status of vitamin K, is associated positively with improved joint structural and functional indices and negatively associated with OA incidence. By contrast, in limited retrospective and prospective studies, the use of VKAs is associated positively with OA occurrence and knee/hip replacement. Pharmacological interactions between VKAs and various OA therapeutic agents exist and require careful monitoring and dosing. In conclusion, further epidemiological studies are warranted to verify the relationship between VKA use and OA to strengthen the evidence. Given that VKA use exerts potentially negative effects on joint health, intervention is required to protect the quality of life and mobility of patients.

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Acknowledgments

The authors thank Universiti Kebangsaan Malaysia for funding them via the Research University Grant (GUP-2020-021).

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Authors and Affiliations

  1. Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Cheras, Malaysia

    Kok-Yong Chin, Sok Kuan Wong & Haji Mohd Saad Qodriyah

  2. Newcastle University Medicine Malaysia, Jalan Sarjana 1, Educity, 79200, Iskandar Puteri, Malaysia

    Kok-Lun Pang

  3. Deparment of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000, Cheras, Malaysia

    Deborah Chia Hsin Chew

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Correspondence to Kok-Yong Chin.

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The authors are supported by Universiti Kebangsaan Malaysia via the Research University Grant (GUP-2020-021).

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All authors were involved in the conceptualisation of the review. K-YC performed the literature review and drafted the manuscript. K-LP, SKW, DCHC and QHMS critically reviewed and provided intellectual input on the manuscript. All authors read and approved the final manuscript.

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Chin, KY., Pang, KL., Wong, S.K. et al. Relationship Amongst Vitamin K Status, Vitamin K Antagonist Use and Osteoarthritis: A Review. Drugs Aging 39, 487–504 (2022). https://doi.org/10.1007/s40266-022-00945-y

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