Knee osteoarthritis (OA) is a joint disease characterized by wear and destruction of cartilage. It is the most common form of OA and is one of the leading causes of disability in the elderly worldwide.
Current treatments (non-medication and medication) are prescribed to maintain function and relieve pain. In case of advanced OA, replacement of the knee joint by surgery may be considered. This procedure can be considered as final stage of knee OA clinical progression. New treatments which could reduce or delay joint damage and clinical progression are under development, with some of them potentially acting more widely on other joint sites with OA.
Our study will use data from primary care to describe the natural history of knee OA in the UK population, with regards to other sites with OA and occurrence of knee replacement. We will describe in which extent patients with knee OA can also suffer from OA in other sites (like the hip, foot or hand), in terms of frequency, number of OA sites and delays between OA diagnosis at the knee and at the other joint sites. We will also estimate the risk of primary knee replacement following a diagnosis of knee OA, according to different types of knee OA and presence of prior OA in other joint sites. Results will improve knowledge of the natural history of knee OA.
This proposal is for a descriptive cohort study whose objective is to describe the natural history of knee osteoarthritis (OA) in the UK, with regards to OA diagnosis at other joint sites and occurrence of knee replacement. Using data from the Clinical Practice Research Datalink (CPRD) Gold and Aurum databases linked to Practice Level Index of Multiple Deprivation as a proxy for socio-economic status, the study will include patients with incident knee OA between January 1, 1988 and December 31, 2018 and follow them until latest available data. Cumulative incidence of key outcomes of interest (OA in new joint site like the hip, foot or hand; number of sites with OA; primary knee replacement) at 1 year, 2-year, 5-year and 10-year following knee OA diagnosis, will be summarised. We will also describe the most frequent sequences of incident sites diagnosed with OA during follow-up. The survival function using Kaplan-Meier estimate will be used to analyse the time to incident OA diagnosis in other joint sites and the time to primary knee replacement following a diagnosis of knee OA. Analyses will be conducted in the whole incident knee OA population as well as in subgroups stratified on type of OA (primary, secondary or unspecified) and presence/absence of OA in other joint sites than knee at baseline, as relevant. The study will be mainly conducted in GOLD. Aurum data will be used in a second phase to gain basic familiarity with this dataset and to see in which extent findings are similar to GOLD.
Joint-specific osteoarthritis (other than knee); Primary knee replacement.
Karine Marinier - Chief Investigator - IRIS - Institut de Recherches Internationales Servier
Karine Marinier - Corresponding Applicant - IRIS - Institut de Recherches Internationales Servier
Agnes Lalande - Collaborator - IRIS - Institut de Recherches Internationales Servier
Ghilas Boussaid - Collaborator - IVIDATA Group
Hanaya Raad - Collaborator - IT&M Stats
Siham Eltaief - Collaborator - IT&M Stats
Practice Level Index of Multiple Deprivation