Knee Osteoarthritis Progression (KOAP)
Introduction:
The KOAP study looked at how quickly knee osteoarthritis progresses in different people and whether we can predict whose arthritis will worsen and whose will not.
Why Do This Research?
Osteoarthritis is the most common joint disease. It affects 10% of people over the age of 63 years and when it occurs in the knee, it causes pain and difficulty with walking. Osteoarthritis starts when people are in their 40s and 50s. However, they are often not diagnosed with it until many years later, because x-rays only begin to detect osteoarthritis when it is already quite advanced. MRI (magnetic resonance imaging) detects osteoarthritis at a much earlier stage than x-rays and detects small changes of worsening of disease better than x-ray. In the KOAP study, we will use MRI in people with early and advanced stages of knee osteoarthritis to determine how the disease progresses and whether we can predict whose arthritis gets worse and whose does not.
The information from the KOAP study will help identify those people who are at high risk of worsening or progression of osteoarthritis, and will help determine who is most likely to benefit from early treatment.
The KOAP study builds on the Early Knee Osteoarthritis (MoDEKO) study, which aims to develop a tool to identify knee osteoarthritis at an early stage. The ability to identify persons with early knee osteoarthritis and to predict their likelihood of progression of disease will allow for appropriate treatment interventions in the future.
Who Is Being Studied?
In the KOAP study, all participants from the MoDEKO study were invited for follow-up assessments. The MoDEKO study included people from the Greater Vancouver area between the ages of 40 and 79 years with knee pain. Participants for the MoDEKO study were selected randomly (by chance) from the population through telephone listings. Of 255 MoDEKO participants, 163 were seen in follow-up in the KOAP study.
How Is It Done?
Participants in the KOAP study were evaluated on average 3 years after the initial visit. Participants were assessed using the same techniques as in the MoDEKO study. They had MRI, x-ray, knee examinations, blood and urine tests for biomarkers, as well as detailed self-reported information on pain and difficulty with activities, such as walking or climbing stairs. MRI was used to determine whose knee osteoarthritis has become worse. This information was then linked to a wide range of factors to assess whether we can predict who is most likely to have progressed.
What Was Found?
Overall, 15.5% of participants had worsening of osteoarthritis, as determined by MRI. Weakness of the quadriceps muscle was identified as one of the risk factors for progression of osteoarthritis. In fact, those with quadriceps weakness were 7 times more likely to have worsening of disease compared to those without quadriceps weakness.
The study data continue to be analysed for other risk factors and further results are expected in 2011.
Why is this Relevant to People Living with Arthritis?
Osteoarthritis is the most common form of arthritis and its occurrence will only increase with the aging of the Canadian population. Because osteoarthritis is common and causes difficulty with many aspects of daily living, the cost to the individual and to society is tremendous.
The identification of specific risk factors that lead to worsening of disease is important, as it will allow for the evaluation of specific treatment interventions in osteoarthritis. In addition, the “tool” that will be developed in this study will lead to a better understanding of which persons are at highest risk of osteoarthritis progression. Once we can identify who is at risk, treatment interventions can be appropriately applied to those groups. In the future, we hope that the information gained from this study will identify new ways to help reduce the progression of knee osteoarthritis.
Are Consumers Involved?
Consumers were involved as participants in this research study.
Who Helped Pay for the Research?
This research was funded by The Arthritis Society of Canada.
Web links:
The Arthritis Society – http://www.arthritis.ca
Team Members:
Study Investigator:
Jolanda Cibere MD, PhD
Research Scientist, ARC
Co-Investigators:
John M. Esdaile MD, MPH
Scientific Director, ARC
Jacek Kopec MD, PhD
Research Scientist, ARC
Joel Singer MD, PhD
Anona Thorne MSc
Hubert Wong PhD
Hongbin Zhang MSc
Savvakis Nicolaou MD
Collaborators:
Ali Guermazi, MD
A. Robin Poole PhD, DSc
Patrick Garnero, PhD, DSc
Virginia Kraus MD, PhD
Tore Saxne MD, PhD
Research Coordinators:
Sherry Trithart, Victoria Combes, Chinh Nguyen, Nicole Prestley
Other Institutions Involved:
University of British Columbia
Vancouver, BC Canada
Centre for Health Evaluation & Outcome Sciences
Vancouver, BC Canada
Vancouver Hospital & Health Sciences Centre
Vancouver, BC Canada
Boston University Medical Center
Boston, MA USA
Joint Diseases Laboratory
Shriners Hospitals for Children
McGill University
Montreal, QC Canada
INSERM Research Unit 664 and Synarc, Lyon, France
Duke University Medical Center, Durham, North Carolina, U.S.A
Lund University Hospital, Lund, Sweden