OBJECTIVE: The Osteoarthritis Research Society International initiated a number of working groups to address a call from the US Food and Drug Administration (FDA) on updating draft guidance on conduct of osteoarthritis (OA) clinical trials. The development of disease-modifying osteoarthritis drugs (DMOADs) remains challenging. The Assessment of Structural Change (ASC) Working Group aimed to provide a state-of-the-art critical update on imaging tools for OA clinical trials. METHODS: The Group focussed on the performance metrics of conventional radiographs (CR) and magnetic resonance imaging (MRI), performing systematic literature reviews for these modalities. After acquiring these reviews, summary and research recommendations were developed through a consensus process. RESULTS: For CR, there is some evidence for construct and predictive validity, with good evidence for reliability and responsiveness of metric measurement of joint space width (JSW). Trials off at least 1 and probably 2 years duration will be required. Although there is much less evidence for hip JSW, it may provide greater responsiveness than knee JSW. For MRI cartilage morphometry in knee OA, there is some evidence for construct and predictive validity, with good evidence for reliability and responsiveness. The responsiveness of semi-quantitative MRI assessment of cartilage morphology, bone marrow lesions and synovitis was also good in knee OA. CONCLUSIONS: Radiographic JSW is still a recommended option for trials of structure modification, with the understanding that the construct represents a number of pathologies and trial duration may be long. MRI is now recommended for clinical trials in terms of cartilage morphology assessment. It is important to study all the joint tissues of the OA joint and the literature is growing on MRI quantification (and its responsiveness) of non-cartilage features. The research recommendations provided will focus researchers on important issues such as determining how structural change within the relatively short duration of a trial reflects long-term change in patient-centred outcomes.
OBJECTIVE: The Osteoarthritis Research Society International initiated a number of working groups to address a call from the US Food and Drug Administration (FDA) on updating draft guidance on conduct of osteoarthritis (OA) clinical trials. The development of disease-modifying osteoarthritis drugs (DMOADs) remains challenging. The Assessment of Structural Change (ASC) Working Group aimed to provide a state-of-the-art critical update on imaging tools for OA clinical trials. METHODS: The Group focussed on the performance metrics of conventional radiographs (CR) and magnetic resonance imaging (MRI), performing systematic literature reviews for these modalities. After acquiring these reviews, summary and research recommendations were developed through a consensus process. RESULTS: For CR, there is some evidence for construct and predictive validity, with good evidence for reliability and responsiveness of metric measurement of joint space width (JSW). Trials off at least 1 and probably 2 years duration will be required. Although there is much less evidence for hip JSW, it may provide greater responsiveness than knee JSW. For MRI cartilage morphometry in knee OA, there is some evidence for construct and predictive validity, with good evidence for reliability and responsiveness. The responsiveness of semi-quantitative MRI assessment of cartilage morphology, bone marrow lesions and synovitis was also good in knee OA. CONCLUSIONS: Radiographic JSW is still a recommended option for trials of structure modification, with the understanding that the construct represents a number of pathologies and trial duration may be long. MRI is now recommended for clinical trials in terms of cartilage morphology assessment. It is important to study all the joint tissues of the OA joint and the literature is growing on MRI quantification (and its responsiveness) of non-cartilage features. The research recommendations provided will focus researchers on important issues such as determining how structural change within the relatively short duration of a trial reflects long-term change in patient-centred outcomes.
Authors: Ilana N Ackerman; Paul A Dieppe; Lyn M March; Ewa M Roos; Anna K Nilsdotter; Graeme C Brown; Karen E Sloan; Richard H Osborne Journal: Arthritis Rheum Date: 2009-02-15
Authors: Clifton O Bingham; J Chris Buckland-Wright; Patrick Garnero; Stanley B Cohen; Maxime Dougados; Silvano Adami; Daniel J Clauw; Timothy D Spector; Jean-Pierre Pelletier; Jean-Pierre Raynauld; Vibeke Strand; Lee S Simon; Joan M Meyer; Gary A Cline; John F Beary Journal: Arthritis Rheum Date: 2006-11
Authors: Ali Guermazi; Deborah Burstein; Philip Conaghan; Felix Eckstein; Marie-Pierre Hellio Le Graverand-Gastineau; Helen Keen; Frank W Roemer Journal: Rheum Dis Clin North Am Date: 2008-08 Impact factor: 2.670
Authors: Maria-Antonietta D'Agostino; Maarten Boers; John Kirwan; Désirée van der Heijde; Mikkel Østergaard; Georg Schett; Robert B Landewé; Walter P Maksymowych; Esperanza Naredo; Maxime Dougados; Annamaria Iagnocco; Clifton O Bingham; Peter M Brooks; Dorcas E Beaton; Frederique Gandjbakhch; Laure Gossec; Francis Guillemin; Sarah E Hewlett; Margreet Kloppenburg; Lyn March; Philip J Mease; Ingrid Moller; Lee S Simon; Jasvinder A Singh; Vibeke Strand; Richard J Wakefield; George A Wells; Peter Tugwell; Philip G Conaghan Journal: J Rheumatol Date: 2014-03-01 Impact factor: 4.666