Prevention of Knee Osteoarthritis in Overweight Females: The First Preventive Randomized Controlled Trial in Osteoarthritis

Runhaar, Jos; Middelkoop, Marienke van; Reijman, Max; Willemsen, Sten P.; Oei, E.H.; Vroegindeweij, Dammis; Osch, Gerjo van; Koes, Bart W.; Bierma-Zeinstra, Sita M A

doi:10.1016/j.amjmed.2015.03.006

Cited by 80 publications

(84 citation statements)

References 25 publications

(13 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The PROOF study used a combined outcome measure of radiographic and clinical knee OA features in order to make a preventive randomized trial with a relatively short followup time feasible (26). In the non-weight loss group, 6% of all knees had incident radiographic knee OA (K/L $2) over the followup period.…”

Section: Discussionmentioning

confidence: 99%

“…A full description of the study protocol can be found elsewhere (26). In short, this 2.5-year followup study aimed to evaluate the preventive effect of a diet and exercise program and oral glucosamine sulfate (double-blind, placebo-controlled) on the onset of knee OA in a 2 3 2 factorial design.…”

Section: Methodsmentioning

confidence: 99%

“…In this randomized clinical trial among middle-aged women with a BMI $27 kg/m 2 without knee OA at baseline, the effects of a diet and exercise program on the incidence of knee OA over 2.5 years was studied. The diet and exercise program did show favorable effects on body weight in the intervention group during the first year of the intervention, and indications of a preventive effect among subjects compliant with the intervention were found (26). The objective of the diet and exercise intervention was a structural weight reduction of 5 kg or 5% of baseline body weight.…”

Section: Introductionmentioning

confidence: 91%

“…For these analyses, participants who met the criteria for that specific outcome measure at baseline were excluded. All GEE analyses were adjusted for the randomized groups of the initial PROOF study and their interaction and for K/L grade at baseline (0 versus $1), since it was shown to be related to the incidence of knee OA (26), and for those factors that were significantly different between the weight loss and non-weight loss groups at baseline. Results from these analyses were presented in odds ratios (ORs) with 95% confidence intervals (95% CIs).…”

Section: Moderate Weight Loss and Knee Oamentioning

confidence: 99%

“…Recently, the first preventive trial in OA research, the Prevention of Knee Osteoarthritis in Overweight Females (PROOF) study, was undertaken (26). In this randomized clinical trial among middle-aged women with a BMI $27 kg/m 2 without knee OA at baseline, the effects of a diet and exercise program on the incidence of knee OA over 2.5 years was studied.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Prevention of Incident Knee Osteoarthritis by Moderate Weight Loss in Overweight and Obese Females

Runhaar

Vos

Middelkoop

et al. 2016

Arthritis Care & Research

Self Cite

View full text Add to dashboard Cite

Objective. This study evaluated the effect of moderate weight loss on the incidence of knee osteoarthritis (OA) in middle-aged overweight and obese women, without clinical and radiologic knee OA at baseline. Methods. A total of 353 women (87%) with followup data available were selected from the Prevention of Knee Osteoarthritis in Overweight Females study, which evaluated the preventive effect of a diet and exercise intervention and of oral glucosamine sulfate on the incidence of knee OA. This was an exploratory proof-of-concept analysis, which compared the incidence of knee OA between women who reached the clinically relevant weight loss target of 5 kg or 5% of body weight after 30 months and those who did not reach this target. Results. The weight loss group showed a significantly lower incidence of knee OA according to the primary outcome measure, which was composed of the American College of Rheumatology criteria (clinical and radiographic), Kellgren/Lawrence grade ‡2, and joint space narrowing ‡1.0 mm (15% versus 20%; odds ratio 0.5, 95% confidence interval 0.3-0.9). Moreover, the weight loss also positively affected several health measures, such as blood glucose level, body fat percentage, and blood pressure. Conclusion. A reduction of ‡5 kg or 5% of body weight over a 30-month period reduces the risk for the onset of radiographic knee OA in middle-aged overweight and obese women. Because of the slow progression of the disease, a longer followup period will be necessary before the number of prevented cases of knee OA by moderate weight loss becomes clinically more relevant.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 91%

Section: Moderate Weight Loss and Knee Oamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Prevention of Incident Knee Osteoarthritis by Moderate Weight Loss in Overweight and Obese Females

Runhaar

Vos

Middelkoop

et al. 2016

Arthritis Care & Research

Self Cite

View full text Add to dashboard Cite

show abstract

Development of Osteoarthritis in Adults With Type 2 Diabetes Treated With Metformin vs a Sulfonylurea

et al. 2023

View full text Add to dashboard Cite

ImportanceMetformin may have a protective association against developing osteoarthritis (OA), but robust epidemiological data are lacking.ObjectiveTo determine the risk of OA and joint replacement in individuals with type 2 diabetes treated with metformin compared with a sulfonylurea.Design, Setting, and ParticipantsThis retrospective cohort study used claims data from the Optum deidentified Clinformatics Data Mart Database between December 2003 and December 2019. Participants included individuals aged 40 years or older with at least 1 year of continuous enrollment and type 2 diabetes. Individuals with type 1 diabetes or a prior diagnosis of OA, inflammatory arthritis, or joint replacement were excluded. Time-conditional propensity score matching was conducted using age, sex, race, Charlson comorbidity score, and treatment duration to create a prevalent new-user cohort. Data were analyzed from April to December 2021.ExposuresTreatment with metformin or a sulfonylurea.Main Outcomes and MeasuresThe outcomes of interest were incident OA and joint replacement. Cox proportional hazard models were used to calculate adjusted hazard ratios (aHRs) of incident OA and joint replacement. In a sensitivity analysis, individuals only ever treated with metformin were compared with individuals only ever treated with a sulfonylurea, allowing for longer-term follow up of the outcome (even after stopping the medication of interest).ResultsAfter time-conditional propensity score matching, the metformin and control groups each included 20 937 individuals (mean [SD] age 62.0 [11.5] years; 24 379 [58.2%] males). In the adjusted analysis, the risk of developing OA was reduced by 24% for individuals treated with metformin compared with a sulfonylurea (aHR, 0.76; 95% CI, 0.68-0.85; P &lt; .001), but there was no significant difference for risk of joint replacement (aHR, 0.80; 95% CI, 0.50-1.27; P = .34). In the sensitivity analysis, the risk of developing OA remained lower in individuals treated with metformin compared with a sulfonylurea (aHR, 0.77; 95% CI, 0.65-0.90; P &lt; .001) and the risk of joint replacement remained not statistically significant (aHR, 1.04; 95% CI, 0.60-1.82; P = .89).Conclusions and RelevanceIn this cohort study of individuals with diabetes, metformin treatment was associated with a significant reduction in the risk of developing OA compared with sulfonylurea treatment. These results further support preclinical and observational data that suggest metformin may have a protective association against the development of OA; future interventional studies with metformin for the treatment or prevention of OA should be considered.

show abstract

Randomized Controlled Trial of an Educational Intervention Using an Online Risk Calculator for Knee Osteoarthritis: Effect on Risk Perception

Losina

Michl

Smith

et al. 2017

Arthritis Care & Research

View full text Add to dashboard Cite

Objective Young adults, in general, are not aware of their risk of knee osteoarthritis (OA). Understanding risk and risk factors is critical to knee OA prevention. We tested the efficacy of a personalized risk calculator on accuracy of knee OA risk perception and willingness to change behaviors associated with knee OA risk factors. Methods We conducted a randomized controlled trial of 375 subjects recruited using Amazon Mechanical Turk. Subjects were randomized to either a) use a personalized risk calculator based on demographic and risk factor information (intervention) or b) view general OA risk information (control). At baseline and after the intervention, subjects estimated their 10-year and lifetime risk of knee OA and responded to contemplation ladders measuring willingness to change diet, exercise, or weight-control behaviors. Results Subjects in both arms had an estimated 3.6% 10-year and 25.3% lifetime chance of developing symptomatic knee OA. Both arms greatly overestimated knee OA risk at baseline, estimating a 10-year risk of 26.1% and a lifetime risk of 47.8%. After the intervention, risk calculator subjects’ perceived 10-year risk decreased by 12.9 percentage points to 12.5% and perceived lifetime risk decreased by 19.5 percentage points to 28.1%. Control subjects’ perceived risks remained unchanged. Risk calculator subjects were more likely to move to an action stage on the exercise contemplation ladder (RR = 2.1). There was no difference between the groups for diet or weight-control ladders. Conclusions The risk calculator is a useful intervention for knee OA education and may motivate some exercise-related behavioral change.

show abstract

Prevention of Knee Osteoarthritis in Overweight Females: The First Preventive Randomized Controlled Trial in Osteoarthritis

Abstract: No significant main effects of the diet-and-exercise program and of glucosamine sulfate were found on incident knee osteoarthritis. Nevertheless, this trial provides valuable insights for future trial design for preventive osteoarthritis studies.

Cited by 80 publications

References 25 publications

Prevention of Incident Knee Osteoarthritis by Moderate Weight Loss in Overweight and Obese Females

Prevention of Incident Knee Osteoarthritis by Moderate Weight Loss in Overweight and Obese Females

Development of Osteoarthritis in Adults With Type 2 Diabetes Treated With Metformin vs a Sulfonylurea

Randomized Controlled Trial of an Educational Intervention Using an Online Risk Calculator for Knee Osteoarthritis: Effect on Risk Perception

Contact Info

Product

Resources

About