Abstract
ObjectivesThe objectives of this prospective observational study were to assess the clinical and radiological changes in hand osteoarthritis (HOA) and to identify the determinants of these changes, over a two year period.Methods203 patients were included in LIège Hand Osteoarthritis Cohort (LIHOC) and followed during 2 years. They met the American College of Rheumatology x-ray/clinical criteria for HOA. At baseline, demographic and clinical characteristics of the population were recorded. Various radiological and clinical parameters were selected to investigate progression.ResultsThe general health measures remained stables over time. The number of nodes increased significantly over 2 years while the other clinical parameters did not vary significantly over time (number of painful joints at rest or at pressure and swollen joints). The pinch force decreased over time and the grip strength remained stable. The two tools accessing function (FIHOA and AUSCAN), showed a progressive deterioration over time (statistically significant for FIHOA (p<0.05) and borderline (p=0.17) significant for the AUSCAN). Almost all patients showed radiologic change during follow-up. Thus, the radiological scores deteriorated significantly over 2 years. An increase in Verbruggen and KL scores was present in 162 (92.04%) and 174 (98.86%) patients, respectively. 39 patients (22.16%) had new erosive joints.From a clinical perspective, using backward logistic regression, diabetes (OR 2.67%–95% CI 1.13–6.33, p=0.03), high degree of radiologic severity (OR 1.23%–95% CI 1.09–1.39, p<0.01) and age between 40 and 60 (OR 2.67%–95% CI 1.21–5.90, p=0.02) at baseline are predictors of FIHOA worsening overtime. The predictors of AUSCAN progression included the pain intensity (OR 0.98%–95% CI 0.97–0.99, p<0.01) and the degree of radiologic severity (OR 1.06%–95% CI 1.01–1.12, p=0.03) at baseline.The following factors are associated with radiological deterioration: symptomatic HOA (OR 2.17%–95% CI 1.04–4.51, p=0.04) and the number of severely affected joints at baseline (OR 1.11%–95% CI 1.04–1.18, p<0.01). In contrast, a high number of erosive or remodelled joints (OR 0.89%–95% CI 0.81–0.98, p=0.02) reduce the risk of radiological disease progression.ConclusionsThese results help to better understand the clinical and radiologic progression of HOA, as well as the determinants that have resulted in them.Disclosure of InterestNone declared