MRI-based screening for structural definition of eligibility in clinical DMOAD trials: Rapid OsteoArthritis MRI Eligibility Score (ROAMES).
Roemer FW, Collins J, Kwoh CK, Hannon MJ ... Felson DT, Hunter DJ, Lynch JA,Guermazi A.
Osteoarthr Cartil 2019 Sep 09
PMID: 31513920 DOI: 10.1016/j.joca.2019.08.005
The reasons for the failure of clinical trials of disease-modifying pharmacologic agents for osteoarthritis treatment are numerous and diverse. One of the main reasons why such trials fail is the heterogeneity of the structural disease and eligibility assessment criteria based on radiography. Osteoarthritis (OA) comprises a spectrum of joint tissue changes that may be categorized as distinct structural phenotypes but are not visualized by X-ray radiography. Magnetic resonance imaging (MRI) is much better suited to structurally characterize a joint but the method has been perceived as being too complex and costly to achieve this goal. This study introduces phenotypic characterization based on a simplified MRI assessment that can be achieved in a rapid fashion. The authors describe a method that is highly reliable and easy to apply. When combined with accelerated image acquisition MRI may be considered mature enough to be applied in large screening endeavours for OA clinical trials. Phenotypic characterization is a crucially important step forward in order to develop better therapeutic strategies that are urgently needed for the most common form of arthritis, for which there are no effective treatments.
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