Identifying determinants of rapid structural and/or clinical progression in knee osteoarthritis by quantitative assessment of structural features on radiographs

通过定量评估射线照片上的结构特征来确定膝骨关节炎快速结构和/或临床进展的决定因素

• 批准号: 10417354
• 负责人: JEFFREY W DURYEA
• 金额: $ 73.89万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-12 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10417354
• 关键词: Address; Adult; Affect; Anterior; Clinical; Clinical Research; Clinical Trials; Computer software; County; Data; Degenerative polyarthritis; Deterioration; Development; Disease; Disease Progression; Enrollment; Evaluation; FDA approved; Goals; Individual; Intervention; Joints; Knee; Knee Osteoarthritis; Location; Longitudinal observational study; Magnetic Resonance Imaging; Measures; Medical; Methods; Morbidity - disease rate; Pain; Premature Mortality; Prevention strategy; Preventive Clinical Trial; Probability; Progressive Disease; Protocols documentation; Public Health; Reproducibility; Research; Research Personnel; Risk; Risk Factors; Roentgen Rays; Sex Differences; Software Tools; Structural defect; Testing; Texture; Time; Visit; Weight-Bearing state; Western Ontario and McMaster Universities Arthritis Index; Width; Work; base; cohort; demographics; experience; high risk; improved; indexing; innovation; insight; knee replacement arthroplasty; novel; prevent; prospective; racial difference; racial diversity; radiological imaging; screening; substantia spongiosa

Abstract Knee osteoarthritis (KOA) is a major public health problem that affects ~30 million US adults, with increased morbidity and premature mortality. KOA has been identified as one of the biggest unmet medical needs because there are no FDA-approved treatments available to prevent, slow or halt OA progression. Development and evaluation of potential OA treatments has been hampered in part by KOA typically being a slowly progressive disease, though progression is variable and some knees undergo rapid structural or clinical progression. Feasible high-throughput methods are needed to gain insights as to how to identify rapid progressors. We have developed a rapid, reproducible, and responsive quantitative software tool, Quantitative Radiographic Software Scores (QROS), to measure minimal joint space width (JSW), fixed JSW (fJSW), variance of 14 fJSW locations; degrees of knee alignment/ malalignment; and orientation and roughness of trabecular bone texture (TBT). The overarching goal of our research is to identify knees at high risk of rapid progression, and our core concept is that quantitative assessment of a novel combination of baseline structural features on radiographs will identify a group of knees with rapid structural and/or clinical progression in KOA. Our central hypothesis is that abnormalities of structural features on knee radiographs will be determinants of varying combinations of worsening rates of structural and/or clinical progression in KOA. Our approach takes advantage of a unique opportunity to innovatively assess radiographic features on ~10,500 individuals by combining three of the largest and most racially diverse longitudinal observational studies of individuals with or at risk of developing KOA: the Johnston County Osteoarthritis Project (JoCoOA), the MulticenterOsteoarthritis Study (MOST), and the Osteoarthritis Initiative (OAI). All three cohorts have fixed flexion, weightbearing knee radiographs that were acquired with identical protocols over multiple visits, and comparable data on demographics, KOA risk factors, and WOMAC pain and function. Our specific aims are: 1). To quantitatively assess structural and clinical progression of KOA, separately and combined; 2). To identify the structural determinants of rapid KOA progression; and 3). To determine the knee- specific probability and time to knee replacement (KR) based on structural and clinical determinants.

抽象的 膝盖骨关节炎（KOA）是影响约3000万美国成年人的主要公共卫生问题，增加了 发病率和过早死亡。 KOA被确定为最大的未满足医疗需求之一 因为没有FDA批准的治疗方法可以预防，因此OA的进展缓慢或停止。 潜在的OA处理的开发和评估部分受到KOA的部分阻碍 缓慢进行性疾病，尽管进展是可变的，有些膝盖经历了快速的结构或临床 进展。 需要可行的高通量方法来获得有关如何识别快速进步者的见解。我们 已经开发了一种快速，可重现和响应迅速的定量软件工具，定量射线照相 软件分数（QRO），测量最小关节空间宽度（JSW），固定JSW（FJSW），方差14 FJSW地点；膝盖比对度/不符合度；小梁骨的方向和粗糙度 纹理（TBT）。 我们研究的总体目标是确定膝盖的高速发展风险，以及我们的核心概念 是对X光片上基线结构特征的新组合的定量评估 识别一组膝盖在KOA中具有快速结构和/或临床进展的膝盖。我们的中心假设是 膝盖X光片上结构特征的异常将是不同组合的决定因素 KOA中结构和/或临床进展的速度恶化。我们的方法利用了独特的 通过组合三个 对患者有或有发展风险的人的最大，最多样化的纵向观察研究 KOA：约翰斯顿县骨关节炎项目（JOCOOA），多中性骨关节炎研究（大多数）和 骨关节炎倡议（OAI）。这三个队列均具有固定的屈曲，体重的膝盖X光片 在多次访问中使用相同的协议获取，以及人口统计学的可比较数据，KOA风险 因素以及WOMAC疼痛和功能。 我们的具体目的是：1）。分别评估KOA的结构和临床进展 合并； 2）。确定快速KOA进展的结构决定因素；和3）。确定膝盖 基于结构和临床决定因素的特定概率和膝盖置换时间（KR）。