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Rheumatology (Oxford). 2015 Jul;54(7):1236-43. doi: 10.1093/rheumatology/keu478. Epub 2015 Jan 7.

Improved prediction of knee osteoarthritis progression by genetic polymorphisms: the Arthrotest Study.

Author information

1
Servicio de Reumatología, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña (UDC), A Coruña, Reumatología, Instituto Poal de Reumatología, Barcelona, Servicio de Reumatología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Servicio de Traumatología, Hospital de León, León, Servicio de Reumatología, Hospital de Sant Pau, Barcelona, Servicio de Reumatología, Hospital José María Morales Meseguer, Murcia, Servicio de Traumatología, Hospital Clínic, Barcelona, Servicio de Reumatología, Parc Salut Mar, Barcelona, Servicio de Reumatología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Servicio de Reumatología, Hospital Plató, Barcelona, Servicio de Reumatología, Hospital Reina Sofía, Córdoba, Servicio de Reumatología, Hospital de Palamós, Palamós, Centro de Salud de Atención Primaria Fuencarral, Madrid, Servicio de Traumatología, Hospital Germans Trias i Pujol, Badalona, Servicio de Reumatología, Corporació Sanitària Parc Taulí, Sabadell, Servicio de Reumatología, Hospital General de Castellón, Castellón, Centro de Salud de Atención Primaria Soto del Real, Madrid, Centro de Salud de Atención Primaria el Limonar, Málaga, Servicio de Reumatología, Hospital de Basurto, Bilbao, Servicio de Traumatología, Centro Médico Teknon, Barcelona, Progenika Biopharma SA, a Grifols Company, Research & Development Department and Research & Development Area, Pharmascience Division, Bioibérica SA, Barcelona, Spain fblagar@sergas.es.
2
Servicio de Reumatología, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña (UDC), A Coruña, Reumatología, Instituto Poal de Reumatología, Barcelona, Servicio de Reumatología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Servicio de Traumatología, Hospital de León, León, Servicio de Reumatología, Hospital de Sant Pau, Barcelona, Servicio de Reumatología, Hospital José María Morales Meseguer, Murcia, Servicio de Traumatología, Hospital Clínic, Barcelona, Servicio de Reumatología, Parc Salut Mar, Barcelona, Servicio de Reumatología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Servicio de Reumatología, Hospital Plató, Barcelona, Servicio de Reumatología, Hospital Reina Sofía, Córdoba, Servicio de Reumatología, Hospital de Palamós, Palamós, Centro de Salud de Atención Primaria Fuencarral, Madrid, Servicio de Traumatología, Hospital Germans Trias i Pujol, Badalona, Servicio de Reumatología, Corporació Sanitària Parc Taulí, Sabadell, Servicio de Reumatología, Hospital General de Castellón, Castellón, Centro de Salud de Atención Primaria Soto del Real, Madrid, Centro de Salud de Atención Primaria el Limonar, Málaga, Servicio de Reumatología, Hospital de Basurto, Bilbao, Servicio de Traumatología, Centro Médico Teknon, Barcelona, Progenika Biopharma SA, a Grifols Company, Research & Development Department and Research & Development Area, Pharmascience Division, Bioibérica SA, Barcelona, Spain.

Abstract

OBJECTIVE:

The aim of this study was to develop a genetic prognostic tool to predict radiographic progression towards severe disease in primary knee OA (KOA) patients.

METHODS:

This investigation was a cross-sectional, retrospective, multicentric association study in 595 Spanish KOA patients. Caucasian patients aged ≥40 years at the time of diagnosis of primary KOA of Kellgren-Lawrence grade 2 or 3 were included. Patients who progressed to Kellgren-Lawrence score 4 or who were referred for total knee replacement within 8 years after diagnosis were classified as progressors to severe disease. Clinical variables of the initial stages of the disease (gender, BMI, age at diagnosis, OA in the contralateral knee, and OA in other joints) were registered as potential predictors. Single nucleotide polymorphisms and clinical variables with an association of P < 0.05 were included in the multivariate analysis using forward logistic regression.

RESULTS:

A total of 23 single nucleotide polymorphisms and the time of primary KOA diagnosis were significantly associated with KOA severe progression in the exploratory cohort (n = 220; P < 0.05). The predictive accuracy of the clinical variables was limited: area under the curve (AUC) = 0.66. When genetic variables were added to the clinical model (full model), the prediction of KOA progression was significantly improved (AUC = 0.82). Combining only genetic variables (rs2073508, rs10845493, rs2206593, rs10519263, rs874692, rs7342880, rs780094 and rs12009), a predictive model with good accuracy was also obtained (AUC = 0.78). The predictive ability for KOA progression of the full model was confirmed on the replication cohort (two-sample Z-test; n = 62; P = 0.190).

CONCLUSION:

An accurate prognostic tool to predict primary KOA progression has been developed based on genetic and clinical information from OA patients.

KEYWORDS:

knee osteoarthritis; radiographic progression; single nucleotide polymorphism

PMID:
25573839
DOI:
10.1093/rheumatology/keu478
[Indexed for MEDLINE]

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