I've been using it for a while now and haven't had any issues with it running along side the various AV/AM I've tried. I've ran it along side SHP, Eset, F-Secure and now WD, without issue. The thing about OSA is that it's not doing any real-time scanning, its more there to monitor access to certian vunerable processes and prevent files from running in certian areas (ie documents folder). The developer has suggested to exclude some of OSA files in your AV/AM to be on the safe side, but it may not be necessary. I have very basic knowledge with OSA, so others with more experience will probably be able to explain it better than I can.
In saying all of this, if you have a product with HIPS, technically OSA really isn't needed, provided that the HIPS is configured properly. For example, Eset has HIPS, but requires configuration. If you were to take the time to configure it, you really don't need OSA at all. Some people (like my self) just ran Eset HIPS in smart mode and ran OSA along side Eset (mostly because I'm too lazy to configure the HIPS), but as I've said it's technically not necessary.