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Individuals with incident accelerated knee osteoarthritis have greater pain than those with common knee osteoarthritis progression: data from the Osteoarthritis Initiative

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Abstract

We evaluated whether accelerated knee osteoarthritis (AKOA) was associated with greater pain and other outcomes and if outcomes varied over time differently among those with incident AKOA or common knee osteoarthritis (KOA), which we defined as a gradual onset of disease. We conducted longitudinal analyses among participants in the Osteoarthritis Initiative who had no radiographic KOA at baseline (Kellgren-Lawrence [KL] <2). Participants were considered AKOA if ≥1 knees progressed to KL grade ≥3 and common KOA if ≥1 knees increased in radiographic scoring within 48 months. We defined the index visit as the study visit when they met the AKOA or common KOA criteria. Our observation period included up to 3 years before and after the index visit. Our primary outcome was WOMAC pain converted to an ordinal scale: none (pain score = 0/1 out of 20), mild (pain score = 2/3), and moderate–severe pain (pain score >3). We explored 11 other secondary outcome measures. We performed an ordinal logistic regression or linear models with generalized estimating equations. The predictors were group (AKOA or common KOA), time (seven visits), and a group-by-time interaction. Overall, individuals with AKOA (n = 54) had greater pain, functional disability, and global rating scale as well as slower chair-stand and walking pace compared with those with common KOA (n = 187). There was no significant interaction between group and time for knee pain; however, there was for chair-stand pace and global rating scale. In conclusion, AKOA may be a painful and disabling phenotype that warrants more attention by clinicians and researchers.

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Acknowledgments

These analyses were supported by grants from the National Institute of Health (Eaton: 268201000020C-1-0-1 and Driban: 1R01AR065977-01A1). The OAI is a public-private partnership comprised of five contracts (N01-AR-2-2258; N01-AR-2-2259; N01-AR-2-2260; N01-AR-2-2261; N01-AR-2-2262) funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners include Merck Research Laboratories; Novartis Pharmaceuticals Corporation, GlaxoSmithKline; and Pfizer, Inc. Private sector funding for the OAI is managed by the Foundation for the National Institutes of Health. This manuscript was prepared using an OAI public use data set and does not necessarily reflect the opinions or views of the OAI investigators, the NIH, or the private funding partners. Dr. Lo is supported by K23 AR062127, an NIH/NIAMS funded mentored award. This work is also supported in part with resources at the VA HSR&D Center for Innovations in Quality, Effectiveness and Safety (#CIN 13-413), at the Michael E. DeBakey VA Medical Center, Houston, TX. This manuscript does not reflect the views of the US government or the Veterans Administration.

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Authors and Affiliations

  1. Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA

    Jeffrey B. Driban & Timothy E. McAlindon

  2. The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, 800 Washington Street, Box #63, Boston, MA, 02111, USA

    Lori Lyn Price

  3. Tufts Clinical and Translational Science Institute, Tufts Medical Center, 800 Washington Street, Box #63, Boston, MA, 02111, USA

    Lori Lyn Price

  4. Center for Primary Care and Prevention, Alpert Medical School of Brown University, 111 Brewster Street, Pawtucket, RI, 02860, USA

    Charles B. Eaton

  5. Brigham & Women’s Hospital and Harvard Medical School, 75 Francis Street PBB-B3, Boston, MA, 02115, USA

    Bing Lu

  6. Medical Care Line and Research Care Line, Houston Health Services Research and Development (HSR&D) Center of Excellence Michael E. DeBakey VAMC, Houston, TX, USA

    Grace H. Lo

  7. Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX. 1 Baylor Plaza, BCM-285, Houston, TX, 77030, USA

    Grace H. Lo

  8. Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Avenue North, AC7-073, Worcester, MA, 01655, USA

    Kate L. Lapane

Authors
  1. Jeffrey B. Driban
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  2. Lori Lyn Price
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  3. Charles B. Eaton
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  4. Bing Lu
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  5. Grace H. Lo
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  6. Kate L. Lapane
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  7. Timothy E. McAlindon
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Corresponding author

Correspondence to Jeffrey B. Driban.

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Ethical standards

Institutional review boards at each OAI clinical site and the OAI coordinating center (University of California, San Francisco) approved the OAI study and all participants provided informed consent prior to participating in the OAI.

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Driban, J.B., Price, L.L., Eaton, C.B. et al. Individuals with incident accelerated knee osteoarthritis have greater pain than those with common knee osteoarthritis progression: data from the Osteoarthritis Initiative. Clin Rheumatol 35, 1565–1571 (2016). https://doi.org/10.1007/s10067-015-3128-2

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  • DOI: https://doi.org/10.1007/s10067-015-3128-2

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