Journal
OSTEOARTHRITIS AND CARTILAGE
Volume 22, Issue 12, Pages 2059-2066Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.joca.2014.09.020
Keywords
Longitudinal change; Magnetic resonance imaging; Knee osteoarthritis; Cartilage thickness; Contra-lateral radiographic knee status
Categories
Funding
- OAI
- National Institutes of Health [N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-22261, N01-AR-2-2262]
- Department of Health and Human Services
- OAI Study Investigators
- Pfizer, Inc.
- Novartis Pharmaceuticals Corporation
- Merck Research Laboratories
- GlaxoSmithKline
- Foundation for the National Institutes of Health
- Pfizer Inc.
- Eli Lilly Co
- Merck-Serono SA
- Glaxo Smith Kline Inc.
- Wyeth Research
- Centocor Research and Development, Inc.
- Novartis Pharma AG
- OAI coordinating center (UCSF)
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Objective: Anti-catabolic disease modifying drugs (DMOADs) aim to reduce cartilage loss in knee osteoarthritis (KOA). Testing such drugs in clinical trials requires sufficient rates of loss in the study participants to occur, preferably at a mild disease stage where cartilage can be preserved. Here we analyze a progression model in mild radiographic KOA (RKOA), based on contra-lateral radiographic status. Methods: We studied 837 participants (62.4 +/- 9 yrs; 30 +/- 4.9 kg/m(2); 61.8% women) from the Osteoarthritis Initiative (OAI) with mild to moderate RKOA (Kellgren Lawrence grade [KLG] 2-3) and with/without Osteoarthritis Research Society International (OARSI) atlas radiographic joint space narrowing (JSN). These had quantitative measurements of subregional femorotibial cartilage thickness from magnetic resonance imaging (MRI) at baseline and 1-year follow-up. They were stratified by contra-lateral knee status: no (KLG 0/1), definite (KLG2) and moderate RKOA (KLG 3/4). Results: KLG2 knees with JSN and moderate contra-lateral RKOA had (P = 0.008) greater maximum subregional cartilage loss -220 mm [95% confidence interval (CI) -255, -184 mm] than those without contra-lateral RKOA -164 mm [-187, -140 mm]. Their rate of subregional cartilage loss was similar and not significantly different (P = 0.61) to that in KLG 3 knees without contra-lateral RKOA (-232 mm; [-266; -198 mm]). The effect of contra-lateral RKOA status was less in KLG2 knees without JSN, and in KLG3 knees. Conclusion: KLG2 knees with JSN and moderate contra-lateral RKOA, display relatively high rates of subregional femorotibial cartilage loss, despite being at a relatively mild stage of RKOA. They may therefore provide a unique opportunity for recruitment in clinical trials that explore the efficacy of anti-catabolic DMOADs on structural progression. (C) 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
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