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See detailMediterranean diet and knee osteoarthritis outcomes: a longitudinal cohort study.
Veronese; Koyanagi, A.; Stubbs, B. et al

in Clinical Nutrition (in press)

Objectives: Mediterranean diet has several beneficial effects on health, but data regarding the association between Mediterranean diet and knee osteoarthritis (OA) are limited mainly to cross-sectional ... [more ▼]

Objectives: Mediterranean diet has several beneficial effects on health, but data regarding the association between Mediterranean diet and knee osteoarthritis (OA) are limited mainly to cross-sectional studies. We investigated whether higher Mediterranean diet adherence is prospectively associated with lower risk of radiographic OA (ROA), radiographic symptomatic knee OA (SxOA) and pain worsening in North American people at high risk or having knee OA. Methods: Adherence to the Mediterranean diet was evaluated using a validated Mediterranean diet score (aMED), categorized in five categories (Q1 to Q5, higher values reflecting higher adherence to Mediterranean diet). Knee OA outcomes included incident (1) ROA, (2) SxOA, as the new onset of a combination of a painful knee and ROA, (3) knee pain worsening, i.e. a Western Ontario and McMaster Universities Osteoarthritis Index difference between baseline and each annual exam of 14%. Results: 4330 subjects (mean age: 61.1 years; 58.0% females) were included. Based on a multivariable Poisson regression analysis, during a mean follow-up period of 4 years, participants who were more highly adherent to a Mediterranean diet (Q5) reported lower risk of pain worsening (relative risk, RR ¼ 0.96; 95% CI: 0.91e0.999) compared to those in Q1. In 2994 people free from SxOA at baseline, higher adherence to a Mediterranean diet was associated with a lower risk for SxOA during follow-up by 9% (Q5 vs. Q1; RR ¼ 0.91; 95% CI: 0.82e0.998). No significant associations emerged between aMED and incident ROA. [less ▲]

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See detailReview of the guideline of the American College of Physicians on the treatment of osteoporosis.
Kanis, J.A.; Cooper, C.; Rizzoli, R et al

in Osteoporosis International (in press)

Summary: This review, endorsed by the International Osteoporosis Foundation and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases ... [more ▼]

Summary: This review, endorsed by the International Osteoporosis Foundation and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases, summarizes several failings of the recent guidelines of the American College of Physicians (ACP) on the treatment of low bone density or osteoporosis to prevent fractures. Introduction: The ACP recently issued guidelines for the treatment of low bone density or osteoporosis to prevent fractures. Methods : Literature review and critical review of the ACP guidelines. Results :The guideline is lacking in scope due to the endorsement of treatment based on T-scores rather than fracture risk assessment and in failure to adequately consider anabolic therapies. Conclusions :The ACP guideline appears outdated. [less ▲]

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See detailExecutive summary of the European guidance for the diagnosis and management of osteoporosis in postmenopausal women.
Kanis, J.A.; Cooper, C.; Rizzoli, R. et al

in Calcified Tissue International (2019), online

A guidance on the assessment and treatment of postmenopausal women at risk from fractures due to osteoporosis was recently published in Osteoporosis International as a joint effort of the International ... [more ▼]

A guidance on the assessment and treatment of postmenopausal women at risk from fractures due to osteoporosis was recently published in Osteoporosis International as a joint effort of the International Osteoporosis Foundation and European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (Kanis et al. in Osteoporos Int https ://doi.org/10.1007/ s0019 8-018-4704-5, 2018). This manuscript updates the previous guidelines document, published in 2013 (Kanis et al. in Osteoporos Int 24:23–57, 2013) and is written in a European perspective. The present article reports and summarizes the main recommendations included in this 2018 guidance document. [less ▲]

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See detailPatients’ preferences for osteoarthritis treatment: the value of stated-preference studies.
Hiligsmann, M.; Pinto, D.; Dennison, E et al

in Aging Clinical and Experimental Research (2019), 31(1), 1-3

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See detailEuropean guidance for the diagnosis and management of osteoporosis
Kanis, J.A.; Cooper, C.; Rizzoli, R et al

in Osteoporosis International (2019), 30(1), 3-44

Summary: Guidance is provided in a European setting on the assessment and treatment of postmenopausal women at risk from fractures due to osteoporosis. Introduction: The International Osteoporosis ... [more ▼]

Summary: Guidance is provided in a European setting on the assessment and treatment of postmenopausal women at risk from fractures due to osteoporosis. Introduction: The International Osteoporosis Foundation and European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis published guidance for the diagnosis and management of osteoporosis in 2013. This manuscript updates these in a European setting. Methods Systematic reviews were updated. Results: The following areas are reviewed: the role of bone mineral density measurement for the diagnosis of osteoporosis and assessment of fracture risk; general and pharmacological management of osteoporosis; monitoring of treatment; assessment of fracture risk; case-finding strategies; investigation of patients; health economics of treatment. The update includes new information on the evaluation of bone microstructure evaluation in facture risk assessment, the role of FRAX® and Fracture Liaison Services in secondary fracture prevention, long-term effects on fracture risk of dietary intakes, and increased fracture risk on stopping drug treatment. Conclusions: A platform is provided on which specific guidelines can be developed for national use. [less ▲]

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See detailAssessment of muscle function and physical performance in daily clinical practice: a position paper endorsed by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO).
Beaudart, Charlotte ULiege; Rolland, Y.; Cruz-Jentoft, A.J. et al

in Calcified Tissue International (2019)

It is well recognized that poor muscle function and poor physical performance are strong predictors of clinically relevant adverse events in older people. Given the large number of approaches to measure ... [more ▼]

It is well recognized that poor muscle function and poor physical performance are strong predictors of clinically relevant adverse events in older people. Given the large number of approaches to measure muscle function and physical performance, clinicians often struggle to choose a tool that is appropriate and validated for the population of older people they deal with. In this paper, an overview of different methods available and applicable in clinical settings is proposed. This paper is based on literature reviews performed by members of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) working group on frailty and sarcopenia. Face-to-face meetings were organized afterwards where the whole group could amend and discuss the recommendations further. Several characteristics should be considered when choosing a tool: (1) purpose of the assessment (intervention, screening, diagnosis); (2) patient characteristics (population, settings, functional ability, etc.); (3) psychometric properties of the tool (test–retest reliability, inter-rater reliability, responsiveness, floor and ceiling effects, etc.); (4) applicability of the tool in clinical settings (overall cost, time required for the examination, level of training, equipment, patient acceptance, etc.); (5) prognostic reliability for relevant clinical outcomes. Based on these criteria and the available evidence, the expert group advises the use of grip strength to measure muscle strength and the use of 4-m gait speed or the Short Physical Performance Battery test to measure physical performance in daily practice. The tools proposed are relevant for the assessment of muscle weakness and physical performance. Subjects with low values should receive additional diagnostic workups to achieve a full diagnosis of the underlying condition responsible (sarcopenia, frailty or other). [less ▲]

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See detailSafety of cyclooxygenase-2 inhibitors in osteoarthritis: outcomes of a systematic review and meta-analysis.
Curtis, E.; Fuggle, N.; Shaw, S. et al

in Drugs and Aging (2019), 36(suppl 1), 25-44

Objective: Our aim was to assess the safety of cyclooxygenase-2 (COX-2) inhibitors in the management of osteoarthritis (OA) in a systematic review and meta-analysis of randomized, placebo-controlled ... [more ▼]

Objective: Our aim was to assess the safety of cyclooxygenase-2 (COX-2) inhibitors in the management of osteoarthritis (OA) in a systematic review and meta-analysis of randomized, placebo-controlled trials. Methods: A comprehensive literature search was undertaken in the databases MEDLINE, Cochrane Central Register of Controlled Trials (Ovid CENTRAL) and Scopus. Randomized, double-blind, placebo-controlled, parallel-group trials that assessed adverse events (AEs) with COX-2 inhibitors in patients with OA were eligible for inclusion. Two authors appraised titles, abstracts and full-text papers for suitability and then assessed the studies for random sequence generation, allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete outcome data and selective outcomes reporting. The primary outcomes of interest were gastrointestinal disorders, cardiac disorders, vascular disorders, nervous system disorders, skin and subcutaneous tissue disorders, hepatobiliary disorders, renal and urinary disorders, as well as overall severe and serious AEs, drug-related AEs and mortality. Secondary outcomes were withdrawals due to AEs (i.e. the number of participants who stopped the treatment due to an AE) and total number of AEs (i.e. the number of patients who experienced any AE at least once). Results: Database searches identified 2149 records from which, after exclusions, 40 trials were included in the meta-analysis. The use of COX-2 inhibitors in OA was associated with a significant increased risk of drug-related AEs compared with placebo (relative risk (RR) 1.26, 95% CI 1.09–1.46; I2 = 24%). The risk of upper gastrointestinal complications (including dyspepsia, gastritis and heartburn) was significantly increased with COX-2 inhibitors versus placebo (RR 1.19, 95% CI 1.03–1.38; I2 = 0%), particularly for abdominal pain, which increased by 40% with COX-2 inhibitors (RR 1.40, 95% CI 1.08–1.80; I2 = 0%). The risk of hypertension increased by 45% overall (RR 1.45, 95% CI 1.01–2.10; I2 = 25%); however, when rofecoxib was removed from the analysis the risk of hypertension in the COX-2 inhibitor group was no longer significant (RR 1.21, 95% CI 0.80–1.83; I2 = 20%). The overall risk of heart failure and edema was increased by nearly 70% with COX-2 inhibitors versus placebo (RR 1.68, 95% CI 1.22–2.31; 0%) and this level of risk did not change appreciably when rofecoxib was excluded (RR 1.67, 95% CI 1.21–2.29; 0%). Conclusions: In our analysis, COX-2 inhibitors were associated with an increased risk of upper gastrointestinal AEs, especially abdominal pain. We also found an increased risk of cardiovascular AEs with COX-2 inhibitors, namely hypertension, heart failure and edema. [less ▲]

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See detailSafety of intra-articular hyaluronic acid injections in osteoarthritis: outcomes of a systematic review and meta-analysis.
Honvo, Germain ULiege; Reginster, Jean-Yves ULiege; Rannou, F. et al

in Drugs and Aging (2019), 36(suppl 1), 101-127

Background: Some controversy exists regarding the safety of intra-articular hyaluronic acid (IAHA) in the management of osteoarthritis (OA). Objective : The objective of this study was to re-assess the ... [more ▼]

Background: Some controversy exists regarding the safety of intra-articular hyaluronic acid (IAHA) in the management of osteoarthritis (OA). Objective : The objective of this study was to re-assess the safety profile of IAHA in patients with OA, through a comprehensive meta-analysis of randomized, placebo-controlled trials. Methods A comprehensive literature search was undertaken in the databases MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus. Randomized, double-blind, placebo-controlled, parallel-group trials that assessed adverse events (AEs) with IAHA in patients with OA were eligible for inclusion. Authors and/or study sponsors were contacted to obtain the full report of AEs. The primary outcomes were overall severe and serious AEs, as well as the following MedDRA System Organ Class (SOC)-related AEs: gastrointestinal, cardiac, vascular, respiratory, nervous system, skin and subcutaneous tissue disorders, musculoskeletal, renal and urinary disorders, infections and infestations, and hypersensitivity reaction. Results: Database searches initially identified 1481 records. After exclusions according to the selection criteria, 22 studies were included in the qualitative synthesis, and nine studies having adequate data were ultimately included in the metaanalysis. From the studies excluded according to the pre-specified selection criteria, 21 with other pharmacological OA treatments permitted during the trials were a posteriori included in a parallel qualitative synthesis, from which eight studies with adequate data were finally included in a parallel meta-analysis. Since this meta-analysis was designed to assess safety, the exclusion criterion on concomitant anti-OA medication was crucial. However, due to the high number of studies that allowed mainly concomitant oral non-steroidal anti-inflammatory drugs (NSAIDs), we decided to include them in a post hoc parallel analysis in order to compare the results from the two analyses. No statistically significant difference in odds was found between IAHA and placebo for all types of SOC-related disorders, except for infections and infestations, for which significantly lower odds were found with IAHA compared with placebo, both overall (odds ratio [OR] = 0.61, 95% confidence interval [CI] 0.40–0.93; I2 = 0%) and in studies without concomitant anti-OA medication (OR = 0.49, 95% CI 0.27–0.89). There were significant increased odds of reporting serious AEs with IAHA compared with placebo, both overall (OR = 1.78, 95% CI 1.21–2.63; I2 = 0%) and in studies with concomitant anti-OA medication (OR = 1.78, 95% CI 1.10–2.89), but not in studies without concomitant anti-OA medication (OR = 1.78, 95% CI 0.92–3.47). Conclusions: Using the available data on studies without any concomitant anti-OA medication permitted during clinical trials, IAHA seems not to be associated with any safety issue in the management of OA. However, this evidence was associated with only a “low” to “moderate” certainty. A possible association with increased risk of serious AEs, particularly when used with concomitant OA medications, requires further investigation. [less ▲]

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See detailSafety of topical non-steroidal anti-inflammatory drugs in osteoarthritis: outcomes of a systematic review and meta-analysis.
Honvo, Germain ULiege; Leclercq, Victoria ULiege; Geerinck, Anton ULiege et al

in Drugs and Aging (2019), 36(suppl 1), 45-64

Objective: We aimed to assess the safety of topical non-steroidal anti-inflammatory drugs (NSAIDs) in the management of osteoarthritis (OA) in a systematic review and meta-analysis of randomized, placebo ... [more ▼]

Objective: We aimed to assess the safety of topical non-steroidal anti-inflammatory drugs (NSAIDs) in the management of osteoarthritis (OA) in a systematic review and meta-analysis of randomized, placebo-controlled trials. Methods: A comprehensive literature search was undertaken in the MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus electronic databases. Randomized, double-blind, placebo-controlled, parallel-group trials that assessed adverse events (AEs) with topical NSAIDs in patients with OA were eligible for inclusion. Authors and/or study sponsors were contacted to obtain the full report of AEs. The primary outcomes were overall severe and serious AEs, as well as the following MedDRA System Organ Class (SOC)-related AEs: gastrointestinal, vascular, cardiac, nervous system, skin and subcutaneous tissue, musculoskeletal and connective tissue. Results The search strategy identified 1209 records, from which 25 papers were included in the qualitative synthesis and 19 were included in the meta-analysis, after exclusions. Overall, more total AEs (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.04–1.29; I2 = 0.0%) and more withdrawals due to AEs (OR 1.49, 95% CI 1.15–1.92; I2 = 0.0%) were observed with topical NSAIDs compared with placebo. The same results were achieved with topical diclofenac, largely driven by an increase in skin and subcutaneous tissue disorders (OR 1.73, 95% CI 0.96–3.10), although the difference was not statistically significant compared with placebo. No significant difference in the odds for gastrointestinal disorders was observed between topical NSAIDs and placebo (OR 0.96, 95% CI 0.73–1.27). Conclusions Topical NSAIDs may be considered safe in the management of OA, especially with regard to low gastrointestinal toxicity. The use of topical NSAIDs in OA should be considered, taking into account their risk: benefit profile in comparison with other anti-OA treatments. [less ▲]

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See detailRecommendations for the reporting harms in manuscripts on clinical trials assessing osteoarthritis drugs: a consensus statement from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO).
Honvo, Germain ULiege; Bannuru, R.R.; Bruyère, Olivier ULiege et al

in Drugs and Aging (2019), 36(suppl 1), 145-159

Background : There is strong evidence of under-reporting of harms in manuscripts on randomized controlled trials (RCTs) compared with the volume of raw data retrieved from these trials. Many guidelines ... [more ▼]

Background : There is strong evidence of under-reporting of harms in manuscripts on randomized controlled trials (RCTs) compared with the volume of raw data retrieved from these trials. Many guidelines have been developed to tackle this, but they have failed to address some important issues that would allow for standardization and transparency. As a consequence, harms reporting in manuscripts remains suboptimal. Objective: The European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) aimed to deliver accurate recommendations for better reporting of harms in clinical trials manuscripts on anti-osteoarthritis (OA) drugs. These could help to better inform clinicians on harms recorded in RCTs and further help researchers conducting meta-analyses. Methods: Using the outcomes of several systematic reviews on the safety of anti-OA drugs, we summarized the ways in which harms have been reported in OA RCT manuscripts to date. Next, we drafted some recommendations and initiated a modified Delphi process that involved a panel of clinicians and clinical researchers to build an expert consensus on recommendations from the ESCEO for the reporting of harms in future manuscripts on RCTs assessing anti-OA drugs. Results: These recommendations emphasize that all treatment-emergent adverse events (AEs) should always be taken into account for harms reporting, with no frequency threshold, and describe how specific AEs should be reported; they also provide a list of the most relevant organ systems to be considered according to each class of drug for reporting of harms within the results section of a manuscript. Irrespective of the drug, the ESCEO recommends that total, severe and serious AEs and withdrawals due to AEs should always be reported; guidance on the reporting of specific events pertaining to each category is provided. The ESCEO also recommends the reporting of information on drug effect on biological parameters, with specific guidance. Conclusions These recommendations may contribute to improve transparency in the field of safety of anti-OA edications. Pharmaceutical companies developing drugs for OA, and researchers conducting clinical trials, are encouraged to comply with them when reporting harms-related results in manuscripts on RCTs. The ESCEO also encourages journals to refer to the ESCEO recommendations in their instructions to authors for the publication of manuscripts on trials of anti-OA medications. [less ▲]

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See detailSafety of opioids in osteoarthritis: outcomes of a systematic review and meta-analysis.
FUGGLE, N; Curtis, E.; Shaw, S. et al

in Drugs and Aging (2019), 36(suppl 1), 129-143

Objective: We aimed to assess the safety of opioids in the management of osteoarthritis (OA) in a systematic review and meta-analysis of randomized, placebo-controlled trials. Methods: A comprehensive ... [more ▼]

Objective: We aimed to assess the safety of opioids in the management of osteoarthritis (OA) in a systematic review and meta-analysis of randomized, placebo-controlled trials. Methods: A comprehensive literature search was undertaken in the MEDLINE, Cochrane Central Register of Controlled Trials (Ovid CENTRAL), and Scopus electronic databases. Randomized, double-blind, placebo-controlled, parallel-group trials that assessed adverse events (AEs) with opioids in patients with OA were eligible for inclusion. Two authors appraised titles, abstracts and full-text papers for suitability and then assessed the studies for random sequence generation, allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete outcome data and selective outcomes reporting. The primary outcomes of interest were gastrointestinal (GI) disorders, cardiac disorders, vascular disorders, nervous system disorders, skin and subcutaneous tissue disorders, renal and urinary disorders, respiratory, thoracic and mediastinal disorders, as well as overall severe and serious AEs and drug-related AEs. Secondary outcomes were withdrawals due to AEs (i.e. the number of participants who stopped the treatment due to an AE) and total number of AEs (i.e. the number of patients who experienced any AE at least once). Results: Database searches identified 2189 records, from which, after exclusions, 17 papers were included in the metaanalysis. More disorders of the lower GI tract (constipation, fecaloma) were reported with both immediate-release (IR) and extended-release (ER) formulations of opioids versus placebo: IR opioids (relative risk [RR] 5.20, 95% confidence interval [CI] 3.42–7.89); ER opioids (RR 4.22, 95% CI 3.44–5.17). The risk of upper GI AEs increased fourfold with ER opioids compared with placebo (RR 4.03, 95% CI 0.87–18.62), and the risk of nausea, vomiting or loss of appetite increased fourto fivefold with both formulations: IR opioids (RR 3.39, 95% CI 2.22–5.18); ER opioids (RR 4.03, 95% CI 3.37–4.83). An increased risk of dermatologic AEs (rash and pruritis; IR opioids: RR 3.60, 95% CI 1.74–7.43; ER opioids: RR 7.87, 95% CI 5.20–11.89) and central nervous system disorders (dizziness, headache, fatigue, somnolence, insomnia; IR opioids: RR 2.76, 95% CI 1.90–4.02; ER opioids: RR 2.76, 95% CI 2.19–3.47) was found with all opioid formulations versus placebo. Conclusions: Our results confirm that there are considerable safety and tolerability issues surrounding the use of opioids in OA, and support the recommendation of international and national guidelines to use opioids in OA after other analgesic options, and for short time periods. [less ▲]

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See detailSafety of oral non-selective non-steroidal anti-inflammatory drugs in osteoarthritis: what does the literature say ?
Cooper, C.; Chapurlat, R.; Al-Daghri, N. et al

in Drugs and Aging (2019), 36(suppl 1), 15-24

Non-steroidal anti-inflammatory drugs (NSAIDs) are widely recommended and prescribed to treat pain in osteoarthritis. While measured to have a moderate effect on pain in osteoarthritis, NSAIDs have been ... [more ▼]

Non-steroidal anti-inflammatory drugs (NSAIDs) are widely recommended and prescribed to treat pain in osteoarthritis. While measured to have a moderate effect on pain in osteoarthritis, NSAIDs have been associated with wide-ranging adverse events affecting the gastrointestinal, cardiovascular, and renal systems. Gastrointestinal toxicity is found with all NSAIDs, which may be of particular concern when treating older patients with osteoarthritis, and gastric adverse events may be reduced by taking a concomitant gastroprotective agent, although intestinal adverse events are not ameliorated. Cardiovascular toxicity is associated with all NSAIDs to some extent and the degree of risk appears to be pharmacotherapy specific. An increased risk of acute myocardial infarction and heart failure is observed with all NSAIDs, while an elevated risk of hemorrhagic stroke appears to be restricted to the use of diclofenac and meloxicam. All NSAIDs have the potential to induce acute kidney injury, and patients with osteoarthritis with co-morbid conditions including hypertension, heart failure, and diabetes mellitus are at increased risk. Osteoarthritis is associated with excess mortality, which may be explained by reduced levels of physical activity owing to lower limb pain, presence of comorbid conditions, and the adverse effects of anti-osteoarthritis médications especially NSAIDs. This narrative review of recent literature identifies data on the safety of non-selective NSAIDs to better understand the risk:benefit of using NSAIDs to manage pain in osteoarthritis. [less ▲]

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See detailNovel approach to estimate osteoarthritis progression: use of the reliable change index in the evaluation of joint space loss.
Parsons, C.; Judge, A.; Leyland, K. et al

in Arthritis Care and Research (2019), 71(2), 300-7

Objective: Osteoarthritis-related changes in joint space measurements over time are small and sensitive to measurement error. The Reliable Change (RC) index determines whether the magnitude of change ... [more ▼]

Objective: Osteoarthritis-related changes in joint space measurements over time are small and sensitive to measurement error. The Reliable Change (RC) index determines whether the magnitude of change observed in an individual can be attributed to true change. This study aimed to examine the RC index as a novel approach to estimating osteoarthritis progression. Methods: Data from 167 men and 392 women with knee osteoarthritis (diagnosed using the ACR criteria) randomised to the placebo arm of the 3-year Strontium Ranelate Efficacy in Knee Osteoarthritis triAl (SEKOIA) and assessed annually. The RC index was used to determine whether the magnitude of change in joint space width (JSW) on radiographs between study years was likely to be true or due to measurement error. Results: Between consecutive years, 57 to 69% of participants had an apparent (change less than 0) decrease in JSW, while 31% to 43% of participants had annual changes indicating improvement in JSW. The RC index identified decreases in JSW in only 6.0% between baseline and year 1 and 4.5% between the remaining study years. The apparent increases in JSW were almost eliminated between baseline and year 1, and between years 1 and 2 only 1.3% had a statistically significant increase, dropping to 0.9% between years 2 and 3. Conclusion: The RC index provides a method to identify change in JSW, removing many apparent changes that are likely to be due to measurement error. This method appears to be useful for assessing change in JSW in clinical and research settings from radiographs. Significance and Innovations: The aim of this research was to assess the effectiveness of the reliable change index as a novel approach to estimating OA progression, to date no studies have been identified that apply the RC index methodology within musculoskeletal research. Interestingly, the reliable change index provides a useful method to identify change in joint space width, removing many of the apparent changes that are likely to be due to measurement error. When compared to crude differences in joint space width measurements, implementation of the reliable change index dramatically reduced the proportions of study participants that were identified as having statically reliable change. This method appears to be useful for assessing change in JSW clinical and research settings from radiographs, and may have wider applications to other imaging modalities. [less ▲]

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See detailPractical guidance for patient-centred health research.
de Wit, M.; Cooper, C.; Reginster, Jean-Yves ULiege et al

in the lancet (2019), 393

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See detailSarcopenia: revised European consensus on definition and diagnosis.
CRUZ-JENTOFT, J; BAHAT, G; BAUER, J et al

in Age and Ageing (2019), 48

Background: in 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a sarcopenia definition that aimed to foster advances in identifying and caring for people with sarcopenia ... [more ▼]

Background: in 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a sarcopenia definition that aimed to foster advances in identifying and caring for people with sarcopenia. In early 2018, the Working Group met again (EWGSOP2) to update the original definition in order to reflect scientific and clinical evidence that has built over the last decade. This paper presents our updated findings. Objectives: to increase consistency of research design, clinical diagnoses and ultimately, care for people with sarcopenia. Recommendations: sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime; sarcopenia is common among adults of older age but can also occur earlier in life. In this updated consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarcopenia diagnosis, and identifies poor physical performance as indicative of severe sarcopenia; (2) updates the clinical algorithm that can be used for sarcopenia case-finding, diagnosis and confirmation, and severity determination and (3) provides clear cut-off points for measurements of variables that identify and characterise sarcopenia. Conclusions: EWGSOP2’s updated recommendations aim to increase awareness of sarcopenia and its risk. With these new recommendations, EWGSOP2 calls for healthcare professionals who treat patients at risk for sarcopenia to take actions that will promote early detection and treatment. We also encourage more research in the field of sarcopenia in order to prevent or delay adverse health outcomes that incur a heavy burden for patients and healthcare systems. [less ▲]

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See detailExecutive summary of European guidance for the diagnosis and management of osteoporosis in postmenopausal women.
Kanis, J.A.; Cooper, C.; Rizzoli, R. et al

in Aging Clinical and Experimental Research (2019), 31

A guidance on the assessment and treatment of postmenopausal women at risk from fractures due to osteoporosis was recently published in Osteoporosis International as a joint effort of the International ... [more ▼]

A guidance on the assessment and treatment of postmenopausal women at risk from fractures due to osteoporosis was recently published in Osteoporosis International as a joint effort of the International Osteoporosis Foundation and European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (Kanis et al. Osteoporos Int, https ://doi.org/10.1007/ s0019 8-018-4704-5, 2018). This manuscript updates the previous guideline document, published in 2013 (Kanis et al. Osteoporos Int 24:23–57, 2013) and is written from a European perspective. The present article reports and summarizes the main recommendations included in this 2018 guidance document (Fig. 1). [less ▲]

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See detailImpact du traitement par statines dans la progression radiologique de la gonarthrose: résultats issus de l'analyse post-hoc de l'essai SEKOIA
Eymard, F.; Parsons, C.; Edwards, M. H. et al

in Revue du Rhumatisme (Edition Francaise) (2019), 86

Objectifs. – Les études épidémiologiques et fondamentales suggèrent que les désordres lipidiques puissent être impliqués dans la physiopathologie de la gonarthrose. Les diverses études ayant évalué ... [more ▼]

Objectifs. – Les études épidémiologiques et fondamentales suggèrent que les désordres lipidiques puissent être impliqués dans la physiopathologie de la gonarthrose. Les diverses études ayant évalué l’effet des statines ont montré des résultats contradictoires. Nous avons étudié l’effet des statines sur la progression radiologique chez des patients atteints d’une gonarthrose symptomatique confirmée sur les radiographies. Méthodes. – 336 patients issus du groupe placebo de l’essai SEKOIA ont complété les 3 ans de suivi et ont été inclus dans cette analyse post-hoc. La prise de statines était évaluée lors de la visite d’inclusion. La mesure de l’interligne articulaire fémoro-tibiale minimale était effectuée sur des radiographies standards selon une méthode automatisée à l’inclusion puis de façon annuelle. La progression radiologique était définie comme un pincement ≥ 0,5 mm sur 3 ans. Résultats. – 71 patients étaient sous statines (21,1 %). Comparativement aux sujets non traités, ils avaient un BMI supérieur (31,1 ± 5,3 vs. 29,3 ± 5,2 kg/m2, p = 0,008) et un plus grand nombre de facteurs métaboliques (≥ 3 facteurs : 43,7 % vs. 7,2 % ; pet < 0,001). La progression radiologique était plus fréquente chez les patients sous statines (49,3 % vs. 32,1 %, pet = 0,007). L’association entre la progression radiologique et l’utilisation de statines était indépendante de l’âge, du sexe, du WOMAC global, de la durée d’évolution, de la sévérité du pincement articulaire, de l’hypertension, du diabète de type 2, de l’obésité (BMI > 30 kg/m2)et des maladies cardiovasculaires [risque relatif 1,49 (IC95 % 1,10–2,02), pet = 0,010]. Conclusion. – Chez les patients ayant une gonarthrose symptomatique, l’utilisation de statines était associée à une plus grande progression radiologique indépendamment des facteurs confondants (obésité, diabète de type 2, hypertension, durée de la maladie, intensité des symptômes et sévérité radiologique). [less ▲]

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See detailGuidelines for the conduct of pharmacological clinical trials in hand osteoarthritis: consensus of a working group of the ESCEO
Reginster, Jean-Yves ULiege; Arden, NK; Haugen, IK et al

in Osteoporosis International (2018, April), 29(Suppl1), 71-2

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