Blood test predicts knee osteoarthritis up to 8 years in advance
Click Here to Manage Email Alerts
Key takeaways:
- The blood biomarker test outperformed traditional measures such as age and BMI.
- Future research on early biomarkers could focus on prevention of pain, disability and joint replacement.
A blood test successfully predicted most knee osteoarthritis cases up to 8 years before signs of the disease first appeared on X-ray, according to data published in Science Advances.
“This confirms our expectation that very early OA is silent and ‘hiding in plain sight’ due to the fact that cartilage tissue has no nerves and therefore can be degraded early on without giving off danger signals of pain,” Virginia B. Kraus, MD, PhD, a professor at the Duke University School of Medicine, told Healio. “Importantly, these findings tell us there is an ‘OA continuum’ from a biological perspective, that actively progressing early-stage OA is similar to later-stage progressive OA — both are driven by an unresolved acute phase inflammatory response.”
Kraus and colleagues developed the blood test to evaluate serum proteomic markers that were shown to predict progression of radiographic knee OA in previous work. For the current analysis, the researchers assessed the blood test’s ability to predict future incidence of radiographic knee OA among a longitudinal cohort of 200 middle-aged U.K. women participating in the Chingford 1000 Women study.
According to Kraus, the cohort was “relatively unique,” as it consisted of women who demonstrated low risk for developing OA based on usual risk factors, such as prior joint injury and baseline knee symptoms.
The researchers analyzed a total of 400 non-depleted serum samples from study participants in year 2 and year 6 using targeted, multiple reaction monitoring mass spectrometry of 165 peptides. The researchers then used machine learning techniques to select the serum proteomic biomarkers most linked to radiographic knee OA incidence at year 10, comparing incident OA cases and age-matched controls.
According to the researchers, six serum peptides corresponding to six proteins demonstrated an area under the curve of 77% to predict the development of OA up to 8 years in advance of X-ray abnormalities. Blood biomarker prediction outperformed “traditional prediction” measures, such as age and BMI, which yielded AUCs of 51% and 57%, respectively, Kraus and colleagues wrote.
“The ability to identify the early OA process by blood biomarker testing can allow clinicians to start thinking of, treating, and monitoring OA the way they think of, treat and monitor the risk for osteoporosis — identified by bone density abnormalities — or heart disease — identified by, among other things, high cholesterol,” Kraus said. “This may prompt earlier intervention of OA, as we do for osteoporosis and heart disease, to prevent end-stage irreversible abnormalities, in this case X-ray changes and disability due to OA.”
Future research could investigate whether early OA biomarkers can be modified for the prevention of pain, disability, radiographic abnormalities and joint replacements in individuals both with and without major joint injury, Kraus added.
“If so, these blood markers could be used to identify high-risk individuals in need of treatment, to monitor individuals to determine if they are getting a drug treatment benefit, and to guide dose selection to maximize their benefit,” she said. “These blood biomarkers could also be used to give early readouts in clinical trials about efficacy of OA drugs, to guide early ‘go/no go’ decisions regarding whether to continue a trial or OA drug development program.”
Collapse
Read more about
Click Here to Manage Email Alerts