BackgroundCurrently a number of risk factors (RF) are considered to be responsible for radiological progression of knee osteoarthritis (OA), nevertheless key predictors of OA progression have not yet been established.ObjectivesTo identify RF predicting radiological progression of knee joint osteoarthritis (OA) in a 5 year multicenter prospective study.MethodsThis study of RF predicting knee OA progression was the first with multicenter prospective design ever conducted in Russia. The study included 344 female patients 40–75 y.o with primary stage I-III knee OA (ACR criteria) from 6 centres. Radiological stage was identified by Kellgren J.- Lawrence J. grading scale. The follow up (FUP) was 5 years. Individual patients’ files described 90 parameters. Instrumental diagnostic methods included plain radiography of knee joints, dual energy X-ray absorptiometry (DEXA) of lumbar spine L1–4, femoral neck and subchondral tibia, ultrasound (US) and MRI examination of knee joints. OA progression was verified based on evolution of radiological stage. At baseline 24 pts (7%) had stage I OA, 227 (66%) – stage II, and 93 (27%) – stage III. Discriminant analysis was applied to verify most reliable RF predicting radiological progression.ResultsRadiological progression was documented in 45% participants during 5 year FUP. The groups with and without progression were comparable in terms of age and disease duration (»<0,05). Pts who progressed suffered more intensive knee pain – 68(52–72) vs 41(30–63) mm, » <0,01, had higher body weight – 82(77–93) vs 72(65–81) kg, » <0,01, had higher rates of knee synovitis (US) 44% vs 26%, »=0,03, (RR=1,67, 95% CI 1,07–2,59) and mid-tibia bone marrow oedema – 60% vs 28%, » <0,01 (RR=2,12, 95% CI 1,34–3,35). The discriminant analysis showed that knee pain, excessive body weight, synovitis and mid-tibia bone marrow oedema (MRI) can be considered as predictors of OA radiological progression. A model capable of predicting OA course in an individual patient with high 88% accuracy, 87.7% sensitivity and 70% specificity has been developed based on identified RF and their coefficients. Area under the ROC-curve 0, 921 (95% CI 0,875–0,966).ConclusionsKnee pain, excessive body weight, synovitis and bone marrow oedema should be considered as key RF predicting knee OA radiological progression.Disclosure of InterestNone declared
ARTRA MSM is rapider in its effect: a significant improvement in Get-Up and Go test results and patient and physician evaluations of the efficiency of treatment. Additional interviews of the patients taking ARTRA MSM demonstrated that 36 (72%) of them reported a prompter pain relief than the ARTRA-treated patients. ARTRA MSM may be recommended for the treatment of OA in clinical practice.
Background:Objectives:To evaluate the relationship between arterial hypertension (AH) and the course of knee osteoarthritis (OA).Methods:The prospective study included 109 women aged 38-75 y.o., of I-III Kellgren J. - Lawrence J. stage of knee OA (ACR), who signed an informed consent. The average age was 59.3 ± 8.7 y.o. (from 38 to 74), the average duration of the OA was 7 (4-12) years. The average values of the body mass index (BMI) corresponded to obesity (30.9 ± 5.4 kg / m2), waist circumference (WC) – 94.4 ± 11.7 cm. An individual card was filled in for each patient, including anthropometric parameters, anamnesis and clinical examination data, assessment of knee joint pain according to VAS, WOMAC, KOOS and DN4 indices, and concomitant diseases. All patients underwent standard X-ray of the knee joints, laboratory examination.Results:AH was diagnosed in 69.7 % patients with OA. Patients were divided into 2 groups, according to the presence or absence of AH (Table 1). Patients with AH were older, had a higher BMI, WC, a longer duration of menopause and significantly earlier its onset (p<0.05). Patients with OA and AH had a more severe course of OA: higher values of pain in VAS, total WOMAC and all its components, DN4, worse indicators of total KOOS (p<0.05). X-ray examination showed a tendency to a more significant narrowing of the medial space of the knee joints (p = 0.07). Laboratory examination showed higher values of CRP, ESR, IL-6, and leptin (p < 0.05).Table 1.Comparative characteristics of OA patients with and without AHParametersPatients with AH(n=76)Patients without AH(n=33)pAge, y.o.61 (57-68)55.5 (49-58)<0.01WC, cm92 (90-105)86.5 (84-90)<0.01Age of menopause, y.o.50 (47-52)55.5 (49-58)0.02Duration of menopause, years14 (7.5-19)7 (4-8)<0.01Duration of OA, years10 (5-15)4 (1-6)0.001VAS pain score, mm49 (40-57)42 (24-50)0.02WOMAC pain, mm189.5 (140-250)140 (108-162)0.001WOMAC stiffness, mm77.5 (42-100)56 (33.5-71.5)0.01WOMAC functional impairment (FI), mm651 (547-902)546.5 (320-663.5)0.002Total WOMAC, mm899 (728-1280)734 (526.5-882)0.001KOOS, points0.47 (0.36-0.57)0.6 (0.53-0.75)<0.01DN4, points2 (1-3)1 (0-2)0.01Overall health status, mm45 (35-55)36.5 (28.5-48.5)0.02The size of the medial space of joint according to X-ray, mm2.45 (1.35-4.35)3.6 (2.8-4.3)0.07CRP, mg/l2.38 (1.47-4.85)1.21 (0.69-2.53)<0.01Leptin, ng/ml37.4 (26.5-53.3)23.6 (15.1-40.2)0.01IL-6, pg/ml0.7 (0.4-1.2)0.45 (0.3-0.7)0.03ESR, mm/h14 (7-18)7 (6-12)0.02We founded positive (р <0.05) associations between AH and a more severe, prolonged course of OA (r=-0.39, p<0.01) in the the Spearman rank-order correlation coefficient analysis. Thus, patients with AH had higher values of VAS pain (r=0.31, p<0.01), total WOMAC (r=0.31, p<0.01) and all its components (pain (r=0.33, p<0.01), FI (r=0.3, p<0.01) and stiffness (r=0.24, p<0.01), DN4 (r=0.24, p=0.01), worse indicators of total KOOS (r=-0.42, p<0.01) and overall health status (r=0.23, p=0.02), more often detected more advanced stage of OA (r=0.24, p=0.03) and synovitis (r=0.23, p=0.01). In addition, positive relationships were found with CRP (r=0.31, p<0.01), IL - 6 (r=0.3, p=0.03), ESR (r=0.3, p=0.02). Positive relationships were confirmed between AH and age (r=0.39, p<0.01), menopause duration (r=0.39, p<0.01), WC (r=0.37, p<0.01), leptin (r=0.35, p=0.01), the presence of hypertriglyceridemia (r=0.35, p=0.01) and cardiovascular risks according to SCORE (r=0.26, p=0.02), considering traditional risk factors for cardiovascular diseases (CVD).Conclusion:Thus, we found that AH in patients with knee OA is affected by a variety of variables, both related to traditional CVD factors and to OA itself, and the correlations found are approximately equal in strength. The results obtained require further study, and it is possible that preventive measures aimed at reducing the traditional risk factors of diseases of the circulatory system, or correcting existing CVD, will contribute to a more favorable course of OA.Disclosure of Interests:None declared
BackgroundObjectivesTo assess efficacy and safety of a single intra-articular injection of a solution combining hyaluronic acid (HA) 60 mg and chondroitin sulphate (CS) 90 mg in 3 mL on patients with knee osteoarthritis (OA) in a multicenter prospective study.Methods79 outpatients (predominantly females - 81,0%) from 5 RF constituent territories with primary tibiofemoral Kellgren-Lawrence score grade II or III knee OA, ≤40 mm pain intensity during walking on visual analogue scale (VAS), requiring NSAIDs intake (for at least 30 days during 3 months prior to enrollment) were included into the study after signing the informed consent form. Mean age was 60,3 ± 8,7 years, mean BMI – 29,2 ± 4,7 kg/m2, disease duration – 6 (3 - 10) years. Grade II OA was documented in 68,4% of patients, Grade III - in 31,6%. The study lasted for 6 months. Efficacy and safety evaluations were made based on VAS pain assessment, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) - (WOMAC pain (0-500), WOMAC function (0-1700), WOMAC stiffness (0-200)), VAS patients’ health status, EQ-5D-based assessment of patients’ quality of life, global physician’s and patient’s efficacy assessment, and daily NSAIDs requirements.ResultsObtained results demonstrate statistically significant VAS pain reduction during walking already in 1 week after intra-articular injection of the combination (respectively, 62 (55-72) and 41 (32-51) mm, p<0,0001). Moreover, pain continued to subside during all 3 months of follow up (in 1 month – 28 (20-42), in 3 months – 22 (14-37) mm). A significant pain reduction achieved at Mo 3 persisted until Mo 6 - 20 (14-42) mm, without documented pain increase (Fig. 1). Similar trends were observed with total WOMAC score (1125 (899-1540) – at baseline, and 552 (309-837) mm – by the end of the study, p<0,0001), and all WOMAC sub-scores (268 (189-312) – baseline WOMAC pain, 91 (48-171) mm – by the end of the study p<0,0001 (Fig. 2); stiffness – 101 (59-130) and 40 (20-61) mm, p<0,0001; function – 802 (647-1095) and 402 (191-638) mm, p<0,0001, respectively). Median time to the onset of therapeutic effect was 7 (5-18) days. Statistically significant improvement of patients’ quality of life by EQ-5D and general health status was observed during all follow up period (respectively, 0,52 (-0,02-0,59) and 0,69 (0,59-0,80), p<0,0001; 48 (30-60) and 72 (60-80) mm, p<0,0001). One injection of the drug resulted in dose reduction or discontinuation of NSAIDs therapy: at baseline 76 patients (96,2%) were taking NSAIDs, in one week 31 (39,2%) patients discontinued NSAIDs, in 1 month – 72,2%, in 3 months – 73,4%, and by the end of the study at Mo 6 – 54,4% were not taking NSAIDs. These data were consistent with physician’s and patient’s global assessment of the efficacy of treatment, who stated «significant improvement» and «improvement» in the majority of cases, with only few “no effect” or “worsening” cases documented in analyzed population. Adverse events, such as worsening of pain and/or swelling of the joint, were documented...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.