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: 10683361
• 负责人: JEFFREY W DURYEA
• 金额: $ 71.04万
• 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/10683361
• 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; cohort; demographics; experience; high risk; improved; indexing; innovation; insight; knee replacement arthroplasty; novel; prevent; progression risk; prospective; racial difference; racial diversity; radiological imaging; screening; structural determinants; 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 膝骨关节炎 (KOA) 是一个主要的公共卫生问题，影响约 3000 万美国成年人，并且发病率逐年增加 发病率和过早死亡。 KOA 已被确定为最大的未满足医疗需求之一 因为目前还没有 FDA 批准的治疗方法可以预防、减缓或阻止 OA 的进展。 潜在 OA 治疗方法的开发和评估在一定程度上受到了阻碍，因为 KOA 通常是一种 疾病进展缓慢，但进展情况各不相同，并且一些膝盖经历快速的结构或临床症状 进展。 需要可行的高通量方法来深入了解如何识别快速进展者。我们 开发了一种快速、可重复且响应灵敏的定量软件工具，定量放射线照相 软件分数 (QROS)，用于测量最小关节间隙宽度 (JSW)，固定 JSW (fJSW)，方差为 14 fJSW 地点；膝关节对齐/错位程度；骨小梁的方向和粗糙度 纹理（待定）。 我们研究的首要目标是识别快速进展高风险的膝盖，我们的核心概念 是对射线照片上基线结构特征的新颖组合的定量评估将 识别一组在 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 膝关节X光片上结构特征的异常将是不同组合的决定因素 KOA 结构和/或临床进展率恶化。我们的方法利用了独特的 通过结合其中的三种方法，有机会创新性地评估约 10,500 人的放射学特征 对患有或有风险的个体进行的规模最大、种族最多样化的纵向观察研究 KOA：约翰斯顿县骨关节炎项目 (JoCoOA)、多中心骨关节炎研究 (MOST) 和 骨关节炎倡议（OAI）。所有三个队列都有固定屈曲、负重的膝关节X光片， 通过多次访视使用相同的方案获得的数据，以及有关人口统计、KOA 风险的可比数据 因素，以及 WOMAC 疼痛和功能。 我们的具体目标是：1）。分别定量评估 KOA 的结构和临床进展 合并； 2）。确定 KOA 快速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膝关节置换（KR）的具体概率和时间。