Pos0965 severity and progression of radiographic hand oa is not associated with progression of radiographic knee oa: the imi-approach cohort

Background Osteoarthritis (OA) frequently affects multiple joints including the knees and hands. Currently, it is unknown which patients with knee OA have the highest risk to progress, and how these patients can be identified. Objectives To investigate the association of radiographic hand OA and its progression with radiographic knee OA progression over two years of follow-up. Methods We used baseline and two-year follow-up data from the Applied Public-Private Research enabling OA Clinical Headway (IMI-APPROACH) cohort. This cohort consists of participants fulfilling the American College of Rheumatology clinical knee OA classification criteria who were likely to have radiographic joint space width loss and/or knee pain progression based on machine learning. Participants and OA characteristics were collected using validated questionnaires and tests. Radiographs of both knees and both hands were scored paired in known time order. Joints were scored according to Kellgren and Lawrence (KL) assessing both knees and both hands (DIPJs, PIPJs, IPJs, MCPJs and CMC1Js (range 0-4 for each joint)). Osteophytes and joint space narrowing (JSN) were scored on 0-3 scales in the bilateral DIPs, PIPs and CMC1s and as absent/present in the IPJs and STTs according to the OARSI atlas, bilateral medial and lateral femoral and tibial osteophytes were scored (0-3 scale), as well as medial and lateral tibiofemoral JSN (0-3 scale). Radiographic knee and hand OA progression were defined as a difference larger than the minimal detectable difference (MDD; based on repeated scoring of 30 radiographs) for the concerning score. Participants that had a knee replacement during follow-up (n=22) were considered as progressors. Logistic regression analyses were used to assess the association of the severity (sum score) or progression of hand OA with knee OA progression for osteophytes, JSN and KL score separately, adjusted for potential confounders (age, sex, BMI and radiographic hand and knee baseline scores). Results There were 222 participants with radiographic data on both knees and both hands at baseline and two years (mean baseline age 66 (standard deviation (SD) 7), 171 (77%) women, mean BMI 27.7 (SD 5.0)). Any radiographic abnormality at baseline (osteophyte, JSN or KL score >0) was present in 195 participants (88%) in any knee and for 217 (98%) in any hand. Baseline and two-year radiographic outcomes are shown in Table 1 . Radiographic hand OA features at baseline were not associated with knee OA progression of the same features (adjusted odds ratio (95% confidence interval (OR (95% CI)) for osteophytes 0.98 (0.95;1.01), for JSN 1.01 (0.98;1.04) and for KL score 1.00 (0.97;1.02)). Osteophyte and KL score progression in the hands were not associated with knee progression of the same features (adjusted ORs 0.62 (95%CI 0.30;1.23) and 0.94 (95%CI 0.42; 2.00), respectively). Those with hand JSN progression had a crude OR of 2.45 (95%CI 1.01;5.70) for knee JSN progression (adjusted: 2.24 (0.88;5.42)). Conclusion Radiographic hand OA severity and progression was not associated with a higher risk of progression of radiographic knee OA. These data indicate that radiographic hand OA does not add to identify radiographic knee OA progressors, and suggest different underlying pathogenetic mechanisms playing a role in these two phenotypes. Table 1. Radiographic hand and knee osteoarthritis scores (n=222) Score (range) Baseline (median, interquartile range) Two years (median, interquartile range) Minimal detectable difference Number of participants with progression (%) Knees Osteophyte sum score (0;24) 4 (1;7) 5 (2;9) 1.1 81 (38%) JSN sum score (0;12) 1 (0;3) 2 (1;4) 1.24 32 (15%) KL sum score (0;8) 3 (1;4) 3 (2;5) 0.65 53 (25%) Hands Osteophyte sum score (0;58) 10 (5;27) 10.5 (6;19) 1.7 60 (28%) JSN sum score (0;58) 4 (1;9) 5 (1;11) 1.98 39 (18%) KL sum score (0;120) 16 (9;27) 17 (10;29) 1.73 55 (26%) Progression was defined as a change larger than minimal detectable difference. Abbreviations: JSN = joint space narrowing, KL = Kellgren and Lawrence. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests Sietse Terpstra Grant/research support from: Received grant from the IMI-APPROACH, all paid to the institution, Lotte A. van de Stadt: None declared, Francis Berenbaum Shareholder of: 4P Pharma, 4Moving Biotech, Consultant of: Boehringer Ing, Galapagos, Gilead, GSK, Merck Serono, MSD, Novartis, Pfizer, Roche, Sanofi, Servier, Viatris, Grant/research support from: TRB Chemedica, Francisco Blanco Grant/research support from: Gedeon Richter Plc., BristolMyers Squibb International corporation (BMSIC), Sun Pharma Global FZE, Celgene Corporation, Janssen Cilag International N.V, Janssen Research & Development, Viela Bio, Inc., Astrazeneca AB, UCB BIOSCIENCES GMBH, UCB BIOPHARMA SPRL, AbbVie Deutschland GmbH & Co.KG, Merck KGaA, Amgen, Inc., Novartis Farmacéutica, S.A., Boehringer Ingelheim España, S.A, CSL Behring, LLC, Glaxosmithkline Research & Development Limited, Pfizer Inc, Lilly S.A., Corbus Pharmaceuticals Inc., Biohope Scientific Solutions for Human Health S.L., Centrexion Therapeutics Corp., Sanofi, MEIJI FARMA S.A., Kiniksa Pharmaceuticals, Ltd, Fundación para la Investigación Biomédica Del Hospital Clínico San Carlos and Grunenthal Pharma., Ida K. Haugen Consultant of: consultancies for Novartis and GSK., Grant/research support from: research grant from Pfizer/Lily (ADVANCE), paid to institution, Floris Lafeber: None declared, Harrie Weinans: None declared, Frits Rosendaal: None declared, Margreet Kloppenburg Grant/research support from: Received grant from the IMI-APPROACH, all paid to the institution.