Severity and progression of structural hand OA is not associated with progression of structural knee OA: The IMI-APPROACH cohort

Sietse E.S. Terpstra , Lotte A. van de Stadt , Francis Berenbaum , Francisco J. Blanco , Ida K. Haugen , Simon C. Mastbergen , Harrie Weinans , Mylène P. Jansen , Frits R. Rosendaal , Margreet Kloppenburg
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Abstract

Objective

To investigate whether structural hand OA or its progression is associated with structural knee OA progression after two years in a population with symptomatic knee OA.

Methods

We used baseline and two-year follow-up data from the IMI-APPROACH cohort. Symptomatic hand and knee OA were defined using ACR criteria. Radiographs of hands and knees were scored semi-quantitatively for osteophytes and joint space narrowing (JSN) following the OARSI atlas, and Kellgren-Lawrence (KL) scale. Knee images were also scored quantitatively with the Knee Image Digital Analysis (KIDA). Progression was defined as change above the minimal detectable change on patient level, except for KIDA (most affected knee compartment level). With logistic regression analyses the severity or progression of hand OA was associated with knee OA progression.

Results

In 221 participants (mean age 66, 77% women, mean BMI 27.7, 19% hand OA), OA progression occurred in 18%–28%, and 9%–38% in hands and knees respectively, depending on features. Baseline structural hand OA features were not significantly associated with knee OA progression, except for hand osteophytes with KIDA osteophytes progression (odds ratio (OR) 1.03, 95% confidence interval (CI) 1.01–1.06). Progression of structural hand OA features was not significantly associated with knee OA progression, except for hand osteophyte or JSN progression, which was significantly associated with knee osteophyte progression (OR 0.44, 95%CI 0.22–0.84 and OR 0.43, 95%CI 0.18–0.94, respectively), and hand osteophyte progression for knee JSN (OR 2.51, 95%CI 1.15–5.48).

Conclusions

In patients with symptomatic knee OA, no consistent associations between baseline structural hand OA or hand OA progression and knee OA progression were shown.

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结构性手部 OA 的严重程度和进展与结构性膝部 OA 的进展无关:IMI-APPROACH 队列
方法我们使用了IMI-APPROACH队列的基线数据和两年随访数据。有症状的手部和膝部OA是根据ACR标准定义的。根据 OARSI 图集和 Kellgren-Lawrence (KL) 量表对手部和膝部的 X 光片进行骨质增生和关节间隙狭窄 (JSN) 的半定量评分。膝关节图像也采用膝关节图像数字分析法(KIDA)进行量化评分。除 KIDA(受影响最严重的膝关节室水平)外,患者水平的变化超过最小可检测到的变化即为病情进展。结果在221名参与者中(平均年龄66岁,77%为女性,平均体重指数27.7,19%为手部OA),根据不同的特征,手部和膝部OA恶化的比例分别为18%-28%和9%-38%。除了手部骨质增生与KIDA骨质增生的进展(几率比(OR)1.03,95%置信区间(CI)1.01-1.06)外,手部OA的基线结构特征与膝关节OA的进展无明显关联。除手部骨质增生或JSN进展与膝部骨质增生进展显著相关外,手部OA结构特征的进展与膝部OA进展无显著相关性(OR值分别为0.44,95%CI为0.22-0.84和OR值分别为0.43,95%CI为0.结论在有症状的膝关节 OA 患者中,基线结构性手部 OA 或手部 OA 进展与膝关节 OA 进展之间没有一致的关联。
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来源期刊
Osteoarthritis and cartilage open
Osteoarthritis and cartilage open Orthopedics, Sports Medicine and Rehabilitation
CiteScore
3.30
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