3 years ago

Predictive validity of radiographic trabecular bone texture in knee OA - The OARSI / FNIH OA biomarkers consortium

Lawrence Whitley, Carl F Pieper, Steve Hoffmann, Michael Nevitt, Jamie E. Collins, Frank Roemer, H Cecil Charles, David J Hunter, Virginia Byers Kraus, Elena Losina, , Ali Guermazi
Objective To evaluate radiographic subchondral trabecular bone texture (TBT) as a predictor of clinically relevant osteoarthritis (OA) progression (combination of symptom and structure worsening). Methods The FNIH OA Biomarkers Consortium undertook a study of progressive knee OA cases (n=194 knees with both radiographic and pain progression over 24-48 months) and comparators (n=406 OA knees not meeting the case definition). TBT parameters were extracted from a medial subchondral tibial region of interest by fractal signature analysis of radiographs using a validated semi-automated software. Baseline TBT and time-integrated values over 12 and 24 months were evaluated for association with case and separately with radiographic and pain progression status adjusted for age, sex, BMI, race, baseline joint space width, WOMAC pain and pain medication use. C-statistics were generated from Receiver Operator Characteristic curves. Results Relative to comparators, cases were characterized by thinner vertical and thicker horizontal trabeculae. The summed composite of three TBT parameters at baseline and over 12 and 24 months best predicted case status (odds ratios 1.24-1.43). The C-statistic for predicting case status using the TBT composite score (0.633-0.649) was improved modestly but statistically significantly over the use of covariates alone (0.608). One TBT parameter, reflecting thickened horizontal trabeculae in cases, at baseline and over 12 and 24 months predicted risk of any progression (radiographic and/or pain progression). Conclusions Although associations are modest, TBT could be an attractive means of enriching OA trials for progressors as it can be generated from screening knee radiographs already standard in knee OA clinical trials. This article is protected by copyright. All rights reserved.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1002/art.40348

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