Recommendations for the use of new methods to assess the efficacy of disease-modifying drugs in the treatment of osteoarthritis

Abadie, Eric; Ethgen, D; Avouac, Bernard; Bouvenot, G; Branco, Jaime; Bruyère, Olivier; Calvo, Gonzalo; Devogelaer, J.-P.; Dreiser, R.-L.; Herrero‐Beaumont, Gabriel; Kahan, André; Kreutz, G.; Laslop, Andrea; Lemmel, Ernst Martin; Nuki, G; Putte, Leo van de; Vanhaelst, L.; Reginster, Jean Yves

doi:10.1016/j.joca.2004.01.006

Cited by 117 publications

(84 citation statements)

References 30 publications

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“…There is a large consensus that the incidence of lower limb surgery is the most relevant clinical outcome, but on practical grounds the assessment of this particular end point would request studies involving massive cohorts of patients over several years. 6 Furthermore, the decision process for osteoarthritis related surgery may be affected by various non-medical conditions, including sex, race, and socioeconomic status. 13 In fact, there are no widely accepted guidelines defining the exact profile of a patient undergoing osteoarthritis related surgery.…”

Section: Discussionmentioning

confidence: 99%

Three year joint space narrowing predicts long term incidence of knee surgery in patients with osteoarthritis: an eight year prospective follow up study

Bruyère

Richy

Reginster

2005

Annals of the Rheumatic Diseases

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Objective: To assess the clinical relevance of mean and minimum femorotibial joint space narrowing (JSN) for predicting future osteoarthritis related surgery in patients with knee osteoarthritis. Methods: 126 subjects with primary knee osteoarthritis were followed prospectively for a mean eight years. Minimum and mean joint space width (JSW) were assessed from standard x rays at baseline and after a follow up of three years. The rate of knee osteoarthritis related surgery was recorded for the following five years. Results: After a mean follow up of eight years, 16 patients (12.7%) had received osteoarthritis related joint surgery. The areas under the curves (AUC) resulting from the receiver operating characteristic curve analyses for predicting osteoarthritis surgery were 0.73 (p = 0.006) for minimum JSN and 0.55 (p = 0.54) for mean JSN. The cut off for minimum JSN maximising sensitivity and specificity for predicting future surgery was a change of 0.7 mm or more in minimum joint space width over a period of three years. However, no meaningful differences were observed for cut off values between 0.5 and 0.8 mm The relative risk (adjusted for age, body mass index, baseline symptoms, and baseline JSW) of experiencing osteoarthritis related surgery during the eight year of follow up was 5.15 (95% confidence interval, 1.70 to 15.60) (p = 0.004) in patients with a minimum joint space narrowing of 0.7 mm or more during the first three years of the study. Conclusions: A cut off of 0.5 to 0.8 mm in minimum JSN, measured on standard x rays, reflects a clinically relevant progression in patients with knee osteoarthritis.

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Section: Discussionmentioning

confidence: 99%

Three year joint space narrowing predicts long term incidence of knee surgery in patients with osteoarthritis: an eight year prospective follow up study

Bruyère

Richy

Reginster

2005

Annals of the Rheumatic Diseases

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“…Currently there exists no accepted medical treatment with structure or disease modification in OA (24)(25)(26)(27)(28)(29)(30)(31), despite the high and vastly increasing number of patients with a need to be treated. In this context, quantitative MRI can help to identify promising drug targets (by identifying tissue components that change first and are responsible for changes in other tissues) and, in particular, to monitor structural effects of drugs in order to prove their effectiveness.…”

Section: Rationale For Quantitative Mri Of Cartilage and Bone In Ostementioning

confidence: 99%

Quantitative MRI of cartilage and bone: degenerative changes in osteoarthritis

2006

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Magnetic resonance imaging (MRI) and quantitative image analysis technology has recently started to generate a great wealth of quantitative information on articular cartilage and bone physiology, pathophysiology and degenerative changes in osteoarthritis. This paper reviews semiquantitative scoring of changes of articular tissues (e.g. WORMS ¼ whole-organ MRI scoring or KOSS ¼ knee osteoarthritis scoring system), quantification of cartilage morphology (e.g. volume and thickness), quantitative measurements of cartilage composition (e.g. T 2 , T 1rho , T 1Gd ¼ dGEMRIC index) and quantitative measurement of bone structure (e.g. app. BV/TV, app. TbTh, app. Tb.N, app. Tb.Sp) in osteoarthritis. For each of these fields we describe the hardware and MRI sequences available, the image analysis systems and techniques used to derive semiquantitative and quantitative parameters, the technical accuracy and precision of the measurements reported to date and current results from cross-sectional and longitudinal studies in osteoarthritis. Moreover, the paper summarizes studies that have compared MRI-based measurements with radiography and discusses future perspectives of quantitative MRI in osteoarthritis. In summary, the above methodologies show great promise for elucidating the pathophysiology of various tissues and identifying risk factors of osteoarthritis, for developing structure modifying drugs (DMOADs) and for combating osteoarthritis with new and better therapy. Copyright # 2006 John Wiley & Sons, Ltd.KEYWORDS: osteoarthritis; joint; cartilage; bone; magnetic resonance imaging; knee; image analysis; disease-modifying drugs RATIONALE FOR QUANTITATIVE MRI OF CARTILAGE AND BONE IN OSTEOARTHRITISThe health and integrity of diarthrodial (synovial) joints are prerequisites for pain-free movement and have a major impact on the quality of life. However, the population of individuals above the age of 65 years is rapidly growing and 70% of the women and 60% of the men aged 65 years or older suffer from degenerative joint disease [¼ osteoarthritis (OA)] (1-7). OA has been defined by the American College of Rheumatology (ACR) as a 'heterogeneous group of conditions that leads to joint symptoms and signs which are associated with defective integrity of articular cartilage, in addition to related changes in the underlying bone at the joint margins'. It remains an open question whether the initial changes take place in cartilage or bone or other articular tissues and, more importantly, what the causal relationship between these changes is (5-19). Also, within each NMR IN BIOMEDICINE NMR Biomed. 2006; 19: 822-854 Published online in Wiley InterScience (www.interscience.wiley.com). DOI:10.1002/nbm.1063 narrowing; JSW, joint space width; K, knee; KLG, Kellgren Lawrence grade; KOSS, knee osteoarthritis scoring system; LF, lateral femoral condyle; LT, lateral tibia; MRI, magnetic resonance imaging; MF, medial femoral condyle; MT, medial tibia; OA, osteoarthritis; OAI, Osteoarthritis Initiative; P, patella; PGs, proteoglycans;...

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“…12,24 Although MRI is a promising technique, it is still too laborious and expensive to perform in routine clinical practice or epidemiologic studies. [25][26][27] Available quantitative methods are taking more time with high costs, but CAJSAM takes not more than two minutes and costs not more than a roentgenogram.…”

Section: 12mentioning

confidence: 99%

Computer-assisted Joint Space Area Measurement: A New Technique in Patients With Knee Osteoarthritis

Ilhanli

Guder²,

Tosun

et al. 2017

Arch Rheumatol

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Objectives: This study aims to assess the validity and reproducibility of computer-assisted joint space area measurement in knee roentgenograms of patients with knee osteoarthritis and compare it with a qualitative method in knee roentgenograms and quantitative and semi-quantitative methods in magnetic resonance imaging. Patients and methods:The study included 40 knees of 40 patients diagnosed as osteoarthritis (14 males, 26 females; mean age 57.4±5.9 years; range 47 to 67 years). Only the patients who wrote consents for publication of their radiologic data, and with knee roentgenograms and magnetic resonance images of the same knees were selected. Computer-assisted measurements were applied to joint spaces by two blinded physicians, for two times with an interval of one week. Data were evaluated for intraobserver and interobserver consistency. Also, data were compared with qualitative (Kellgren-Lawrence classification), quantitative (joint space width, cartilage thickness, meniscal thickness in magnetic resonance images) and semi-quantitative methods (whole-organ magnetic resonance imaging score). Results: Intraobserver consistency was evaluated for each physician, which revealed no differences. Interobserver consistency was evaluated by comparing the measurements of two blinded physicians and no differences were found (p>0.05). There was no significant correlation between the grade of Kellgren-Lawrence classification and other variables; such as grade of meniscus, meniscal thickness, cartilage thickness and computerassisted joint space area measurements (p>0.05). While there was a positive correlation between computer-assisted joint space area measurement and other quantitative measurements, there was a negative correlation between computer-assisted joint space area measurement and whole-organ magnetic resonance imaging scores. Conclusion: When compared with qualitative, quantitative, and semi-quantitative methods, computer-assisted joint space area measurement seems to be a useful, reproducible, and cost-effective quantitative method for evaluating knee osteoarthritis.

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Recommendations for the use of new methods to assess the efficacy of disease-modifying drugs in the treatment of osteoarthritis

Abstract: GREES has outlined a set of guidelines for the development of a DMOAD for OA. Although these guidelines are subject to change as new information becomes available, the information above is based on the present knowledge in the field with the addition of expert opinion.

Cited by 117 publications

References 30 publications

Three year joint space narrowing predicts long term incidence of knee surgery in patients with osteoarthritis: an eight year prospective follow up study

Three year joint space narrowing predicts long term incidence of knee surgery in patients with osteoarthritis: an eight year prospective follow up study

Quantitative MRI of cartilage and bone: degenerative changes in osteoarthritis

Computer-assisted Joint Space Area Measurement: A New Technique in Patients With Knee Osteoarthritis

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