Biomarkers Predict Total Joint Replacements in Patients With Osteoarthritis

By Louise Gagnon

TORONTO -- May 8, 2019 -- Specific biomarkers predictive the need for total joint replacement (TJR) in patients with osteoarthritis (OA), according to a study presented here at the Osteoarthritis Research Society International (OARSI) 2019 World Congress.

“Osteoarthritis is the most common indication for total joint replacement,” said Jonathan J. Bjerre-Bastos, MD, Nordic Bioscience Clinical Development, Copenhagen, Denmark. “Total joint replacement is an expensive procedure associated with complications and a portion of patients continue to have pain after surgery.”

The role of collagens in structural joint components has been studied and may offer insight on patients with knee OA who are at risk of TJR. Biomarkers of extracellular matrix turnover can possibly predict a high risk of joint failure and the need for TJR, said Dr. Bjerre-Bastos.

The researchers performed a post-hoc analysis, looking at data from 2 clinical trials that involved the use of oral supplements. They included subjects with available baseline serum CTX-I and urine CTX-II for biomarker analyses. There were a total of 27 TJRs, 19 knee replacements, and 8 hip replacements.

Investigators compared the risk of TJR of the knee or hip in patients with high versus low biomarker values using statistical analysis that controlled for age, sex, and body mass index.

Results showed that high baseline urine CTX-II was significantly associated with an elevated (3.08 times) risk of undergoing a TJR of the knee or hip during the period of study (P = .04).

For risk of knee replacement alone, patients with elevated CTX-I had an 8.94 times elevated risk.

Elevated baseline sCTX-I was associated with a 3.4 times higher risk of undergoing knee or hip replacement (P = .04). However, this biomarker did not attain statistical significance for risk of knee arthroplasty alone (P = .15).

Dr. Bjerre-Bastos said that the study be replicated in another cohort with a sample size that is larger and longer duration.

Funding for this study was provided by Nordic Bioscience.

[Presentation title: Biomarkers of Bone and Cartilage Turnover CTX-I and CTX-II Predict Total Joint Replacements in Osteoarthritis. Abstract 12]
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