Biomarkers Predict Total Joint Replacements in Osteoarthritis Patients

Osteoarthritis (OA) in major joints ultimately leads to joint failure for which the only curative treatment is total joint replacement. This procedure is associated with risk of complications and approximately 20% continue to experience pain.

Biomarkers may act as tools in investigating the association between biochemical and pathological processes and risk of joint failure. C-telopeptide of cross-linked collagen type I (CTX-I) and C-telopeptide of cross-linked collagen type II (CTX-II) are both considered biomarkers that may reflect disease progression in OA.

Scientists from the Krembil Research Institute (Toronto, ON, Canada) performed a post-hoc analysis, looking at data from two clinical trials that involved the use of oral supplements. They included subjects with available baseline serum CTX-I and urine CTX-II for biomarker analyses. There were a total of 27 total joint replacements (TJR), 19 knee replacements, and eight hip replacements. Investigators compared the risk of TJR of the knee or hip in patients with high versus low biomarker values using statistical analysis that controlled for age, sex, and body mass index.

The team showed that high baseline urine CTX-II was significantly associated with an elevated (3.08 times) risk of undergoing a TJR of the knee or hip during the period of study. For risk of knee replacement alone, patients with elevated CTX-I had an 8.94 times elevated risk. Elevated baseline serum CTX-I was associated with a 3.4 times higher risk of undergoing knee or hip replacement. However, this biomarker did not attain statistical significance for risk of knee arthroplasty alone.

Jonathan J. Bjerre-Bastos, MD, from Nordic Bioscience (Copenhagen, Denmark), and the lead author of the study, said, “Osteoarthritis is the most common indication for total joint replacement. Total joint replacement is an expensive procedure associated with complications and a portion of patients continue to have pain after surgery.” The study was published in the April 2019 issue of the journal Osteoarthritis and Cartilage.

Related Links:
Krembil Research Institute
Nordic Bioscience