POS1094 SYNOVITIS IS FACTOR OF OSTEOARTHRITIS KNEE PROGRESSION IN PATIENTS WITH LESS THAN 5 YEARS OF DISEASE DURATION
Authors: L. Alekseeva, N. Kashevarova, E. Taskina, D. Kusevich
Journal: Annals of the Rheumatic Diseases (2021)

Background: There are many studies about investigation of risk factors (RF) of knee osteoarthritis (OA) radiologic progression. Especially, in patients with small disease duration. At the moment, there are ambivalent of results of previous studies, lead to uncertain role of synovitis. Objectives: The aim of study is to investigate relationship between knee OA synovitis and progression risk in patients with small disease duration during a follow-up period of 5 years. Methods: Eligible patients had knee OA based on ACR criteria with x-ray confirmation; baseline (BL) disease duration less than 5 years. Patients were evaluated at BL and at 5-year follow-up, using the questionnaires, clinical examination, knee joints pain by visual analog scale (VAS), musculoskeletal ultrasound and X-ray. Unadjusted p-values are presented. Results: Among 52 adults with knee OA (mean age ± standard deviation, 59.11 ± 8.95 years; 100% female) had the proportion of patients at BL 42.3% (n=22), 46.2 % (n=24), 11.5% (n=6) by disease stage 1,2 and 3, respectively. Patients were categorized into 2 groups by progression during 5 years from BL based on changes of radiological stage. After 5-years follow-up period the progression of knee OA was established in 14 patients (1 group) and in 38 patients (2 group) the progression by radiological stage was absent. BL patients’ characteristics were similar across 1st and 2nd groups: mean age 58.29±7.68 vs 56.05±8.74, р&gt;0.05; disease duration 3.43±1.34 vs 3.47±1.33, р&gt;0.05. Individuals with knee OA progression had worse knee joints pain during walking (60.36±18.33 vs 48.71±17.81, р=0.043), higher body mass index (BMI) (34.45±4.60 vs 28.92±4.92 kg/m 2 , р=0.001), higher frequency of knee synovitis by clinical examination (42.9% vs 10.5%, RR=4.07; 95%Cl (1,3-12,3), р=0.01) and by musculoskeletal ultrasound (57.1% vs 18.4%, RR=3.1; 95%CI (1.38-6.96), р=0.009). At 5-years follow-up knee pain was significantly greater for 1st group (69.64±18,49 vs 55.76±12.76, р = 0.003), higher BMI (35.74±5.83 vs 30.64±4.64, р = 0.002), also higher frequency of knee synovitis by clinical examination (57.1% vs 10.5%, RR = 5.4 (95%Cl 1.9-15.2), р=0.001) and by musculoskeletal ultrasound (50% vs 13.2%, RR=3.8 (95%Cl 1.4-10.0), р=0.009). Spearman correlation coefficients between radiologic stage and OA progression factors were indicated: between radiologic stage and knee pain during walking (r = 0.34, p&lt;0.05), BMI (r = 0.46, p&lt;0.01), knee synovitis by musculoskeletal ultrasound (r = 0.41, p&lt;0.01). Multivariate (discriminant) analysis was determined that synovitis is a significant predictor of radiographic progression (p &lt; 0.05). Conclusion: The proportion of patients with knee synovitis by clinical examination and musculoskeletal ultrasound data increased by 5-year follow-up from BL. Synovitis is a significant predictor of radiographic progression of knee OA in patients with small disease duration. Disclosure of Interests: None declared. Figure 1.