Body weight changes and corresponding changes in pain and function in persons with symptomatic knee osteoarthritis: A cohort study

Virginia Commonwealth University, Department of Physical Therapy, PO Box 980224, Richmond, VA 23298-0224. .
Arthritis care & research 01/2013; 65(1). DOI: 10.1002/acr.21692
Source: PubMed


OBJECTIVE: To determine if a dose-response relationship exists between percentage body weight changes in persons with symptomatic knee osteoarthritis (OA) and self reported pain and function. METHODS: Data from persons in the Osteoarthritis Initiative (OAI) and the Multicenter Osteoarthritis (MOST) datasets (n=1,410) with symptomatic function limiting knee OA were studied. For the OAI, we used baseline and 3-year follow-up data while for the MOST, baseline and 30-month data were used. Key outcome variables were WOMAC Physical Function and Pain change scores. In addition to covariates, the predictor variable of interest was the extent of weight change over the study period and divided into 5 categories representing different percentages of body weight change. RESULTS: A significant dose-response relationship (p< 0.003) was found between the extent of percentage change in body weight and the extent of change in WOMAC Physical Function and WOMAC Pain. For example, persons who gained ≥10% of body weight had WOMAC Physical Function score changes of -5.4 (95%CI, -8.7, -2.00) points indicating worsening relative to the reference group of persons with weight changes of between <5% weight gain and <5% weight reduction. CONCLUSION: Our data suggest a dose-response relationship exists between changes in body weight and corresponding changes in pain and function. The threshold for this response gradient appears to be ≥10% body weight shifts. Weight changes of ≥10% have potential to lead to important changes in pain and function for patient groups as well as individual patients. © 2012 by the American College of Rheumatology.

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    • "Knee pain is the most common and disabling symptom of Osteoarthritis (OA) [1] [2]. This disease affects 1 in every 10 adults over 60 years in the United States and the rate of incidence is incrementing due to changes in lifestyle and life expectancy [3] [4] [5] [6] [7]. The prevalence and the symptomatic importance of pain in OA subjects make pain prediction a very important task for the management of OA patients. "
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    ABSTRACT: In this work, the potential of X-ray based multivariate prognostic models to predict the onset of chronic knee pain is presented. Using X-rays quantitative image assessments of joint-space-width (JSW) and paired semiquantitative central X-ray scores from the Osteoarthritis Initiative (OAI), a case-control study is presented. The pain assessments of the right knee at the baseline and the 60-month visits were used to screen for case/control subjects. Scores were analyzed at the time of pain incidence (T-0), the year prior incidence (T-1), and two years before pain incidence (T-2). Multivariate models were created by a cross validated elastic-net regularized generalized linear models feature selection tool. Univariate differences between cases and controls were reported by AUC, C -statistics, and ODDs ratios. Univariate analysis indicated that the medial osteophytes were significantly more prevalent in cases than controls: C -stat 0.62, 0.62, and 0.61, at T-0, T-1, and T-2, respectively. The multivariate JSW models significantly predicted pain: AUC = 0.695, 0.623, and 0.620, at T-0, T-1, and T-2, respectively. Semiquantitative multivariate models predicted paint with C -stat = 0.671, 0.648, and 0.645 at T-0, T-1, and T-2, respectively. Multivariate models derived from plain X-ray radiography assessments may be used to predict subjects that are at risk of developing knee pain.
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    • "Weight loss relieves pain in obese OA patients, with a weight loss of at least 10 % providing significant pain reduction [48] . A recent study in individuals with symptomatic knee OA suggested a dose–response relationship between changes in body weight and corresponding changes in pain and physical function [49]. To date, no small animal models of obesity-induced OA have evaluated the effect of specific interventions on pain, but trials in overweight dogs confirm that exercise and weight loss may have a positive effect on pain and gait [50, 51]. "
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    ABSTRACT: Animal models of osteoarthritis are extensively used for investigating disease pathways and for preclinical testing of novel therapies. Their predictive utility, however, has often been questioned, mainly because preclinical efficacy of novel therapeutics is poorly translated in clinical trials. In the current narrative review, we consider the preclinical models that were used to support undertaking clinical trials for disease-modifying osteoarthritis drugs, and compare outcomes between clinical and preclinical studies. We discuss this in light of the 1999 Food and Drug Administration draft guidelines for industry for use in the development of drugs, devices, and biological products intended for the treatment of osteoarthritis, which raised five considerations on the usefulness of osteoarthritis models. We systematically discuss what has been learnt regarding these five points since 1999, with emphasis on replicating distinct risk factors and subtypes of human osteoarthritis, and on comprehensive evaluation of the disease in animals, including pathology of all joint tissues, biomarker analysis, and assessment of pain and joint function. Finally, we discuss lessons learnt and propose some recommendations for how the evidence from preclinical research might be strengthened with a view to improving success in clinical translation.
    Full-text · Article · Sep 2015 · Arthritis research & therapy
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