The Intensive Diet and Exercise for Arthritis (IDEA) trial: 18-month radiographic and MRI outcomes

Abstract

Despite the potent effects of weight loss in this study on symptoms as well as mechanistic outcomes (such as joint compressive force and markers of inflammation), there was no statistically significant difference between the three active interventions on the rate of structural progression either on X-ray or MRI over 18-months.

Is Weight Loss Associated with Less Progression of Changes in Knee Articular Cartilage among Obese and Overweight Patients as Assessed with MR Imaging over 48 Months? Data from the Osteoarthritis Initiative

“…In addition, only participants in whom MR imaging could be performed were included in the OAI study; thus, participants who had issues with fitting into the MR imaging surgery). Yet, the only statistical trend found in the previous assessment of structural knee abnormalities and different types of weight loss (exercise, diet, and diet combined with exercise) was a beneficial effect for both dietary groups regarding progression of BMEP (63). Of note, this previous study was performed over a much shorter period, which may explain the lack of differences between cartilage thickness and volume, as well as the denuded area, between the groups with different weight loss methods.…”

Association of adipokines and joint biomarkers with cartilage-modifying effects of weight loss in obese subjects

“…While a recent study by Hunter et al with similar numbers of patients 45 , did not observe an association between weight loss and cartilage changes on MRI, the authors found a trend towards improvements in bone marrow lesions (BMLs). Given the association with BMLs and pain 46 , this may be of particular clinical relevance.…”

Effects of dietary weight loss with and without exercise on interstitial matrix turnover and tissue inflammation biomarkers in adults with knee osteoarthritis: the Intensive Diet and Exercise for Arthritis trial (IDEA)

“…The diet only group also exhibited a significant decrease in knee compressive forces. Despite these improvements, there were no significant differences in changes in knee joint structural outcomes, including radiographic joint space narrowing and, in a subset of participants, MRI measures 6 .…”

“…The 6- and 18-month samples were collected at least 24 hours after the last acute bout of exercise training and sampling was postponed (1–2 weeks after recovery from symptoms) in the event of an acute respiratory, urinary tract, or other infection. Bilateral, posteroanterior, weight-bearing, knee x-rays were obtained with the participants’ knees flexed at 15 degrees using a positioning device (Synaflexer) as described 6 .…”

“…The methods used to measure joint space width in the IDEA study have been published 6 as well as the criteria used to define progressors and non-progressors 19 . In brief, the minimum joint space width (mJSW) was measured in digitized radiographic images using an automated software application.…”