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Short-term clinical worsening is a clear predictor for worsening at 2 years in established knee and hip osteoarthritis
E.A. Mahler1, A.A. Den Broeder2, N. Den Broeder3, J.W. Bijlsma4, G.F. Snijders5, F.H. Van Den Hoogen6, C.H. Van Den Ende7
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands. e.mahler@maartenskliniek.nl
- Department of Rheumatology, Sint Maartenskliniek and Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands.
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands.
- Department of Rheumatology and Clinical Immunology, University Medical Centre Utrecht, Utrecht, The Netherlands.
- Department of Rheumatology, Sint Maartenskliniek and Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands.
- Department of Rheumatology, Sint Maartenskliniek and Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands.
- Department of Rheumatology, Sint Maartenskliniek and Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands.
CER11252
2019 Vol.37, N°3
PI 0414, PF 0421
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PMID: 30299244 [PubMed]
Received: 17/03/2018
Accepted : 02/07/2018
In Press: 17/09/2018
Published: 10/05/2019
Abstract
OBJECTIVES:
Our aim was to estimate the proportion of knee and hip OA patients showing worsening at 2 years, and to examine the additional predictive value of failure of optimised non-surgical treatment during 3 months for worsening at 2 years.
METHODS:
Data of patients participating in the longitudinal CONTROL-PRO study (patients fulfilling clinical ACR criteria for knee or hip OA) were used. Measurements of pain, functioning and patient global assessments were performed at baseline, 3 months and 2 years. Worsening at 2 years was defined as fulfilling the recently validated clinical worsening criteria for knee and hip OA, or total joint replacement (TJR). Logistic regression was performed with worsening at 2 years as the dependent variable.
RESULTS:
The 297 included patients were predominantly women (66%) with a mean age of 55 years. At 2 years, 61% showed worsening (knee 59%; hip 71%) and 24% had undergone a TJR (knee 19%; hip 51%). Clinical worsening at 3 months appeared to be a clear independent predictor for worsening at 2 years (OR 2.8 95% CI 1.5–5.2) with a moderate discriminative ability (AUC 0.68 95% CI 0.57–0.70). Similar results were obtained when only TJR at 2 years was used as the outcome measure (OR 4.1 95% CI 2.0–8.4) with good AUC (0.82 95% CI 0.76–0.87).
CONCLUSIONS:
Our findings suggest that re-assessment of symptoms after optimised non-surgical treatment could be meaningful in clinical decision making for TJR. Furthermore, this information could be used to identify subgroups of patients potentially eligible for novel and advanced treatment options.