Long-term Significance of Pre-radiographic Lesions in Persons at Risk for Knee OA

膝关节骨关节炎风险人群放射前病变的长期意义

• 批准号: 8612440
• 负责人: Leena Sharma
• 金额: $ 110.54万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8612440
• 关键词: American; Ancillary Study; Bone Marrow; Cartilage; Clinic; Clinical; Clinical Trials Design; Contracture; Data; Data Collection; Degenerative polyarthritis; Development; Disease; Disease Progression; Epidemiologic Studies; Event; Funding; Future; Individual; Intervention; Investigation; Knee; Knee Osteoarthritis; Knowledge; Learning; Lesion; Life; Literature; Longevity; Longitudinal Studies; Magnetic Resonance Imaging; Measures; Motion; Nature; Onset of illness; Organ; Participant; Patient Self-Report; Performance; Persons; Physical Examination; Physical Function; Prevention strategy; Process; Reliance; Reporting; Rheumatology; Risk; Risk Factors; Symptoms; System; Time; Tissues; Visit; Woman; Work; base; bone; clinical research site; clinically significant; college; follow-up; high risk; men; prevent; public health relevance; research clinical testing; success; therapy development; American; Ancillary Study; Bone Marrow; Cartilage; Clinic; Clinical; Clinical Trials Design; Contracture; Data; Data Collection; Degenerative polyarthritis; Development; Disease; Disease Progression; Epidemiologic Studies; Event; Funding; Future; Individual; Intervention; Investigation; Knee; Knee Osteoarthritis; Knowledge; Learning; Lesion; Life; Literature; Longevity; Longitudinal Studies; Magnetic Resonance Imaging; Measures; Motion; Nature; Onset of illness; Organ; Participant; Patient Self-Report; Performance; Persons; Physical Examination; Physical Function; Prevention strategy; Process; Reliance; Reporting; Rheumatology; Risk; Risk Factors; Symptoms; System; Time; Tissues; Visit; Woman; Work; base; bone; clinical research site; clinically significant; college; follow-up; high risk; men; prevent; public health relevance; research clinical testing; success; therapy development

DESCRIPTION (provided by applicant): A major barrier to development of disease-modifying therapy for knee osteoarthritis (OA) is the nature of disease progression, a downward spiral involving many tissues. The potential for changing disease course may be highest before this process is in motion. The literature documents cartilage, bone, and meniscal lesions by MRI in knees of some older individuals without radiographic OA, but does not reveal whether they represent early OA. We propose a long-term, longitudinal study to evaluate the clinical significance of such lesions in persons at higher risk for knee OA but without OA in either knee by x-ray at baseline, to advance knowledge of early OA and to help to identify an earlier (than x-ray affords) OA onset window. We have a highly unique opportunity to carry out this study. The Osteoarthritis Initiative (OAI), a study of 4796 individuals with or at higher risk for knee OA, ens follow-up at 96 months. 1244 participants had no x-ray findings of knee OA in either knee at baseline. We propose an additional visit of this subcohort (1226 living) at 120 months to collect data (some not collected after baseline and some not after the 48 month visit) that would enable comprehensive evaluation of clinical definitions of OA at the furthest feasible time point while the OAI clinical sites are still constituted, as well as assessment of MR images being collected at 96 months. The proposed aims are unique, time-sensitive, and could not be completed within the OAI's scope of work. We propose 3 aims in OAI participants in this subcohort: 1) evaluate the association between each lesion - cartilage damage, bone marrow lesion, meniscal tear, meniscal extrusion - by MRI at baseline and risk of incident knee OA by the historic (and current) radiographic criterion by 120 months and by recently proposed MRI criteria by 96 months; 2) evaluate the association between each lesion by MRI at baseline and risk of incident clinical features of knee OA, including ACR criteria, flexion contracture, and persistent knee symptoms by 120 months; and 3) explore the association between each lesion by MRI at baseline and baseline-to-120-month physical function decline by performance and self-report measures of function. Proposed study findings will enable future identification of risk factors for clinically important early lesions and prevention strategies that could be introduced earlier in th lifespan. Ultimately, clinically significant lesions might become a target of disease-modifying intervention at a point when success may be more realizable, before the whole-organ progression spiral.

描述（由申请人提供）：膝关节骨关节炎（OA）发展疾病改良疗法的主要障碍是疾病进展的性质，疾病进展的性质，涉及许多组织的向下螺旋。在此过程中，改变疾病病程的可能性可能是最高的。文献记录了MRI的软骨，骨骼和半月板病变，其中一些没有放射线OA的年长个体的膝盖，但并未透露它们是否代表早期OA。我们提出了一项长期的纵向研究，以评估此类病变在膝盖OA风险较高的人中的临床意义，但在基线时通过X射线进行X射线，以提高对早期OA的了解，并帮助识别早期（比X射线比较）OA发作窗口。我们有一个非常独特的机会来进行这项研究。骨关节炎倡议（OAI），对4796名患有膝关节OA风险或更高风险的人，在96个月时随访。 1244名参与者在基线时没有膝盖OA的X射线检查结果。我们在120个月时提议对这一子体系（1226居住）进行额外访问，以收集数据（有些在基线后未收集，有些未在48个月后收集），这将能够全面评估OA在最远的可行时间点的OA临床定义，而OAI临床站点仍然构成了96个月的MR图像。提出的目标是独特的，时间敏感的，无法在OAI的工作范围内完成。我们提出了3个亚ai的OAI参与者的目标：1）评估每个病变之间的关联 - 软骨损伤，骨髓病变，半月板撕裂，半月板挤压 - 基线时MRI以及最近通过96个月的MIRI CRITERIA通过96个月的历史性（和当前的射线照相标准）在历史悠久（和当前的射线照射标准）中。 2）评估MRI在基线时通过MRI和膝关节临床特征的风险评估每个病变之间的关联，包括ACR标准，屈曲签订和持续的膝盖症状在120个月内； 3）探索MRI在基线时通过绩效和自我报告功能测量的基线到120个月的身体功能下降的每个病变之间的关联。拟议的研究结果将使未来确定风险因素 临床上重要的早期病变和预防策略可以在寿命早期引入。最终，在整个器官进展之前，在成功可能更可实现的时刻，临床意义的病变可能成为改良疾病改良干预的靶标。