TY - JOUR
T1 - How to define responders in osteoarthritis
AU - Cooper, Cyrus
AU - Adachi, Jonathan D.
AU - Bardin, Thomas
AU - Berenbaum, Francis
AU - Flamion, Bruno
AU - Jonsson, Helgi
AU - Kanis, John A.
AU - Pelousse, Franz
AU - Lems, Willem F.
AU - Pelletier, Jean Pierre
AU - Martel-Pelletier, Johanne
AU - Reiter, Susanne
AU - Reginster, Jean Yves
AU - Rizzoli, René
AU - Bruyère, Olivier
PY - 2013/6/1
Y1 - 2013/6/1
N2 - Background: Osteoarthritis is a clinical syndrome of failure of the joint accompanied by varying degrees of joint pain, functional limitation, and reduced quality of life due to deterioration of articular cartilage and involvement of other joint structures. Scope: Regulatory agencies require relevant clinical benefit on symptoms and structure modification for registration of a new therapy as a disease-modifying osteoarthritis drug (DMOAD). An international Working Group of the European Society on Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and International Osteoporosis Foundation was convened to explore the current burden of osteoarthritis, review current regulatory guidelines for the conduct of clinical trials, and examine the concept of responder analyses for improving drug evaluation in osteoarthritis. Findings: The ESCEO considers that the major challenges in DMOAD development are the absence of a precise definition of the disease, particularly in the early stages, and the lack of consensus on how to detect structural changes and link them to clinically meaningful endpoints. Responder criteria should help identify progression of disease and be clinically meaningful. The ideal criterion should be sensitive to change over time and should predict disease progression and outcomes such as joint replacement. Conclusion: The ESCEO considers that, for knee osteoarthritis, clinical trial data indicate that radiographic joint space narrowing >0.5 mm over 2 or 3 years might be a reliable surrogate measure for total joint replacement. On-going research using techniques such as magnetic resonance imaging and biochemical markers may allow the identification of these patients earlier in the disease process.
AB - Background: Osteoarthritis is a clinical syndrome of failure of the joint accompanied by varying degrees of joint pain, functional limitation, and reduced quality of life due to deterioration of articular cartilage and involvement of other joint structures. Scope: Regulatory agencies require relevant clinical benefit on symptoms and structure modification for registration of a new therapy as a disease-modifying osteoarthritis drug (DMOAD). An international Working Group of the European Society on Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and International Osteoporosis Foundation was convened to explore the current burden of osteoarthritis, review current regulatory guidelines for the conduct of clinical trials, and examine the concept of responder analyses for improving drug evaluation in osteoarthritis. Findings: The ESCEO considers that the major challenges in DMOAD development are the absence of a precise definition of the disease, particularly in the early stages, and the lack of consensus on how to detect structural changes and link them to clinically meaningful endpoints. Responder criteria should help identify progression of disease and be clinically meaningful. The ideal criterion should be sensitive to change over time and should predict disease progression and outcomes such as joint replacement. Conclusion: The ESCEO considers that, for knee osteoarthritis, clinical trial data indicate that radiographic joint space narrowing >0.5 mm over 2 or 3 years might be a reliable surrogate measure for total joint replacement. On-going research using techniques such as magnetic resonance imaging and biochemical markers may allow the identification of these patients earlier in the disease process.
KW - Magnetic resonance imaging
KW - Osteoarthritis
KW - Pain
KW - Responder
KW - Structure-modifying drug
KW - X-ray
UR - http://www.scopus.com/inward/record.url?scp=84877292873&partnerID=8YFLogxK
U2 - 10.1185/03007995.2013.792793
DO - 10.1185/03007995.2013.792793
M3 - Article
C2 - 23557069
AN - SCOPUS:84877292873
SN - 0300-7995
VL - 29
SP - 719
EP - 729
JO - Current Medical Research and Opinion
JF - Current Medical Research and Opinion
IS - 6
ER -