Trajectories of Structural Disease Progression in Knee Osteoarthritis
Year: 2020
Type: article
Abstract: OBJECTIVE: Knee osteoarthritis (OA) is a heterogeneous disease, with most patients experiencing slow disease progression and some with rapid deterioration. We aimed to identify groups of patients with symptomatic knee OA experiencing rapid structural progression. METHODS: We selected participants from the Osteoarthritis Initiative with baseline Kellgren/Lawrence (K/L) grades 1-3 and knee pain, and with joint space width (JSW) on fixed-flexion knee radiographs assessed at baseline and with ≥1 follow-up over 8 years. We used latent class growth analysis to identify subgroups of JSW progression, jointly modeling time to knee replacement (KR) to account for potential informative dropouts. After identifying trajectories, we used logistic regression to assess the association between baseline characteristics and the JSW trajectory group. RESULTS: We used data from 1,578 participants. Baseline radiographic severity was K/L grade 1 in 17%, K/L grade 2 in 50%, and K/L grade 3 in 33%. We identified 3 distinct JSW trajectories: 86% stable, 6% with stable JSW followed by late progression, and 8% with early progression. Incorporating information about KR resulted in 47% of KRs initially classified as stable being reclassified to 1 of the progressing trajectories. Prior knee surgery was associated with being in the late-progressing versus the stable trajectory, while obesity was associated with being in the early-progressing versus stable trajectory. CONCLUSION: In addition to a subgroup of individuals experiencing early structural progression, 8-year longitudinal data allowed the identification of a late-progressing trajectory. Incorporating information about KR was important to properly identify longitudinal structural trajectories in knee OA.
Source: Arthritis Care & Research
DOI: 10.1002/acr.24340
Authors: Jamie E. Collins, Tuhina Neogi, Elena Losina
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G1158108047, G166592988, The Role of Urate in Knee Osteoarthritis-Related Inflammation, Pathology and Pain, Clinical Centers for the Osteoarthritis Initiative, Data Coordinating Center for the Osteoarthritis Initiative, G482432850, Clinical Centers for the Osteoarthritis Initiative, G5672476635, G724008290, Clinical Centers for the Osteoarthritis Initiative^Rhode Island, Patient Oriented Research and Mentoring Program in Orthopedics, Clinical Centers for the Osteoarthritis Initiative, Boston University CCCR, VERITY: Value and Evidence in Rheumatology using bioInformaTics, and advanced analYtics
OpenAlex ID: W3032257218