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Short-term clinical worsening is a clear predictor for worsening at 2 years in established knee and hip osteoarthritis


1, 2, 3, 4, 5, 6, 7

 

  1. Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands. e.mahler@maartenskliniek.nl
  2. Department of Rheumatology, Sint Maartenskliniek and Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands.
  3. Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands.
  4. Department of Rheumatology and Clinical Immunology, University Medical Centre Utrecht, Utrecht, The Netherlands.
  5. Department of Rheumatology, Sint Maartenskliniek and Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands.
  6. Department of Rheumatology, Sint Maartenskliniek and Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands.
  7. 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.

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