Knee osteoarthritis phenotypes and their relevance for outcomes: a systematic review
| Autor: | Kathryn Mills, Leticia A Deveza, Tiê Parma Yamato, David J. Hunter, Varshini Ravi, L. Melo |
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| Rok vydání: | 2017 |
| Předmět: |
Cartilage
Articular medicine.medical_specialty Biomedical Engineering MEDLINE CINAHL Osteoarthritis Severity of Illness Index Body Mass Index External validity 03 medical and health sciences 0302 clinical medicine Sex Factors Rheumatology Internal medicine medicine Humans Orthopedics and Sports Medicine 030212 general & internal medicine Muscle Strength Obesity Pain Measurement 030203 arthritis & rheumatology Central Nervous System Sensitization business.industry Osteoarthritis Knee medicine.disease Phenotype Arthralgia Physical therapy Disease Progression Observational study Disease characteristics business Body mass index Stress Psychological |
| Zdroj: | Osteoarthritis and cartilage. 25(12) |
| ISSN: | 1522-9653 |
| Popis: | Summary Objective To systematically review the literature for studies investigating knee osteoarthritis (OA) phenotypes to examine what OA characteristics are relevant for phenotyping. Methods A comprehensive search was performed in Medline, EMBASE, Web of Sciences, CINAHL, and Scopus databases from inception to September 2016. Inclusion was limited to observational studies of individuals with symptomatic knee OA that identified phenotypes based on any OA characteristics and assessed their association with clinically important outcomes. A descriptive synthesis of the data was performed. Results Of the 2777 citations retrieved, 34 studies were included. Clinical phenotypes were investigated most frequently, followed by laboratory, imaging and aetiologic phenotypes. Eight studies defined subgroups based on outcome trajectories (pain, function and radiographic progression trajectories). Most studies used a single patient or disease characteristic to identify patients subgroups while five included characteristics from multiple domains. We found evidence from multiple studies suggesting that pain sensitization, psychological distress, radiographic severity, body mass index (BMI), muscle strength, inflammation and comorbidities are associated with clinically distinct phenotypes. Gender, obesity and other metabolic abnormalities, the pattern of cartilage damage, and inflammation may be implicated in delineating distinct structural phenotypes. Only a few studies investigated the external validity of the phenotypes or their prospective validity using longitudinal outcomes. Conclusions There is marked heterogeneity in the data selected by the studies investigating knee OA phenotypes. We identified the phenotypic characteristics that can be considered for a comprehensive phenotype classification in future studies. A framework for the investigation of phenotypes could be useful for future studies. Protocol registration PROSPERO CRD42016036220. |
| Databáze: | OpenAIRE |
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