References of "Reginster, Jean-Yves"
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See detailEffects of 3 months of controlled whole body vibrations with low exposure period on the risk of falls among nursing home residents
Beaudart, Charlotte ULg; Maquet, Didier ULg; Mannarino, Mélanie et al

in Proceeding of the meeting (2013, February 22)

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See detailComment on Freemantle et al. : Results of indirect and mixed treatment comparison of fracture efficacy for osteoporosis treatements
Brandi, ML; Reginster, Jean-Yves ULg; Rizzoli, R et al

in Osteoporosis International (2013), 24(6), 1929-30

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See detailCost-effectiveness of strontium ranelate in the treatment of male osteoporosis.
Hiligsmann, Mickaël ULg; Ben Sedrine, Wafa ULg; Bruyère, Olivier ULg et al

in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA (2013)

The results of this study suggest that, under the assumption of same relative risk reduction of fractures in men as for women, strontium ranelate could be considered a cost-effective strategy compared ... [more ▼]

The results of this study suggest that, under the assumption of same relative risk reduction of fractures in men as for women, strontium ranelate could be considered a cost-effective strategy compared with no treatment for the treatment of osteoporotic men from a Belgian healthcare payer perspective. INTRODUCTION: This study was conducted to estimate the cost-effectiveness of strontium ranelate in the treatment of osteoporotic men. METHODS: A previously validated Markov microsimulation model was adapted to estimate the cost (<euro>2,010) per quality-adjusted life-year (QALY) gained of strontium ranelate compared with no treatment. Similar efficacy data on lumbar spine and femoral neck bone mineral density (BMD) between men with osteoporosis at high risk of fracture (MALEO Trial) and postmenopausal osteoporotic women (pivotal SOTI, TROPOS trials) supports the assumption, in the base-case analysis, of the same relative risk reduction of fractures in men as for women. Analyses were conducted, from a Belgian healthcare payer perspective, in the population from the MALEO Trial who is a men population with a mean age of 73 years, and BMD T-score </=-2.5 or prevalent vertebral fracture (PVF). RESULTS: In the MALEO population, strontium ranelate compared with no treatment was estimated at <euro>49,798 and <euro>25,584 per QALY gained using efficacy data from the intent-to-treat analysis and the per-protocol analysis including only adherent patients, respectively. In men with a BMD T-score </=-2.5 or with PVF, the cost per QALY gained of strontium ranelate fall below thresholds of <euro>45,000 and <euro>25,000 per QALY gained based on efficacy data from the entire population of the clinical trial and from the per-protocol analyses, respectively. CONCLUSIONS: The results of this study suggest that, under the assumption of same relative risk reduction of fractures in men as for women, strontium ranelate could be considered cost-effective compared with no treatment for male osteoporosis. [less ▲]

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See detailPerception et comportement de recours aux soins de santé dans les pays en voie de développement. Le cas de la République Démocratique du Congo
Manzambi Kuwekita, Joseph ULg; Reginster, Jean-Yves ULg

Book published by Les Editions du Céfal - Tous droits de reproduction, d'adaptation et de traduction réservés pour tous pays. (2013)

L’objectif principal de cet ouvrage consistait à identifier les facteurs du comportement de recours aux soins de santé dans la ville de Kinshasa. Neuf facteurs historiques (1909-1960) ont été dégagés ... [more ▼]

L’objectif principal de cet ouvrage consistait à identifier les facteurs du comportement de recours aux soins de santé dans la ville de Kinshasa. Neuf facteurs historiques (1909-1960) ont été dégagés comme facteurs influant sur l’offre et l’utilisation actuelles des soins de santé à Kinshasa : (i) gratuité des soins, (ii) présence du médecin, (iii) implication des religieuses dans l’offre des soins, (iv) convention d’agrément par l’État d’hôpitaux et de dispensaires fondés par les missions religieuses afin de les subsidier, (v) exclusion de la population dans la conception, l’organisation et la gestion du système de santé mis en place, (vi) exclusion du tradipraticien du système des soins, (vii) les noirs immatriculés étaient détachés de la coutume indigène et se rapprochaient plus des Européens que des autochtones, (viii) l’enseignement et la santé étaient confiés aux mains des missions religieuses, avec une préférence pour les catholiques, (ix) le budget du secteur santé était de 12% du budget du gouvernement. De même, de 1960 à 1995, dix facteurs ont été identifiés comme influant sur l’offre et l’utilisation actuelles des soins de santé à Kinshasa : (i) mise en place d’un système à 2 échelons (fonctionnant pratiquement avec un seul échelon), excluant l’hôpital général, (ii) les animateurs de la participation communautaires est le médecin chef de zone ou l’infirmier titulaire, (iii) les membres du personnel des zones de santé sont nommés par le ministère et ceux du centre de santé par son propriétaire, (iv) la population joue le rôle de bénéficiaire passif dans le système en place, (v) absence de la population dans les organes de gestion des soins de santé primaires, (vi) mise en place d’un système comprenant moins de 10% des structures des soins disponibles, (vii) pour constituer le comité de santé, le médecin chef de zone consulte les autorités locales qui l’aident à identifier des groupes d’interlocuteurs, (viii) les fonds alloués au premier échelon sont gérés par les experts et/ou parrains et non par la population, (ix) exclusion du médecin du premier échelon, (x) système dépendant financièrement de l’aide extérieure. <br />Les résultats de l’enquête de ménage menée en 1997 montre que lors de la perception d’un problème de santé par les populations de Kinshasa, sept possibilités de recours sont exploitées : le centre de santé est le plus sollicité, suivi du dispensaire privé, l’automédication pharmaceutique, le tradipraticien, l’automédication traditionnelle, la polyclinique conventionnée et l’hôpital de référence. La régression logistique a montré que l’on recourt d’autant plus au centre de santé qu’à une autre structure de soins lorsqu’on recherche la qualité des soins, l’application de bons tarifs et l’offre de services polyvalents. Par contre, le souci de proximité géographique par rapport au lieu de résidence du ménage appelle à utiliser le dispensaire privé. Lorsqu’on recherche la présence d’un médecin ou l’existence d’une convention on choisit plutôt la polyclinique privée conventionnée. Ceux qui ont cherché une solution à un type particulier de maladie ont choisi plutôt le tradipraticien. La lecture des résultats de cette étude montre que si les populations choisissent les soins offerts par le centre de santé, c’est parce qu’elles les jugent de bonne qualité. Des soins intégrés et offerts par le même technicien, de formation requise, sont un atout majeur à l’acceptabilité du premier échelon des soins de santé primaires à Kinshasa. La proximité géographique est également une raison importante pour s’adresser à une autre structure que le centre de santé. Il est peu probable que 109 centres de santé qui doivent encore être mis en place pour réaliser le plan de couverture verront le jour à court terme. Une alternative serait d’intégrer les structures de soins privées non officielles dans le système des soins de santé primaires, pour autant qu’elles puissent atteindre un niveau de qualité comparable à celui des centres de santé. Concernant l’accessibilité financière des structures de soins, l’étude suggère qu’en dialogue avec la population, des modes de financement et de tarification en vigueur ou à mettre au point soient étudiés pour diminuer les barrières financières aux soins de qualité. Pour que le tradipraticien puisse jouer un rôle complémentaire important dans la réalisation des soins de santé primaires, même en milieu urbain, il est suggéré d’étudier la possibilité de privilégier des lieux de communication. [less ▲]

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See detailOsteoporosis
Reginster, Jean-Yves ULg; Bruyère, Olivier ULg; Cianferotti, Luisella et al

Book published by Future Medicine Ltd (2013)

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See detailNominal group technique to select attributes for discrete choice experiments: an example for drug treatment choice in osteoporosis.
Hiligsmann, Mickaël ULg; VAN DURME, Caroline ULg; Geusens, Piet et al

in Patient Preference and Adherence (2013), 7

BACKGROUND: Attribute selection represents an important step in the development of discrete-choice experiments (DCEs), but is often poorly reported. In some situations, the number of attributes identified ... [more ▼]

BACKGROUND: Attribute selection represents an important step in the development of discrete-choice experiments (DCEs), but is often poorly reported. In some situations, the number of attributes identified may exceed what one may find possible to pilot in a DCE. Hence, there is a need to gain insight into methods to select attributes in order to construct the final list of attributes. This study aims to test the feasibility of using the nominal group technique (NGT) to select attributes for DCEs. METHODS: Patient group discussions (4-8 participants) were convened to prioritize a list of 12 potentially important attributes for osteoporosis drug therapy. The NGT consisted of three steps: an individual ranking of the 12 attributes by importance from 1 to 12, a group discussion on each of the attributes, including a group review of the aggregate score of the initial rankings, and a second ranking task of the same attributes. RESULTS: Twenty-six osteoporotic patients participated in five NGT sessions. Most (80%) of the patients changed their ranking after the discussion. However, the average initial and final ranking did not differ markedly. In the final ranking, the most important medication attributes were effectiveness, side effects, and frequency and mode of administration. Some (15%) of the patients did not correctly rank from 1 to 12, and the order of attributes did play a role in the ranking. CONCLUSION: The NGT is feasible for selecting attributes for DCEs. Although in the context of this study, the NGT session had little impact on prioritizing attributes, this approach is rigorous, transparent, and improves the face validity of DCEs. Additional research in other contexts (different decisional problems or different diseases) is needed to determine the added value of the NGT session, to assess the optimal ranking/rating method with control of ordering effects, and to compare the attributes selected with the different approaches. [less ▲]

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See detailEfficacy and safety of strontium ranelate in the treatment of knee osteoarthritis: results of a double-blind, randomised placebo-controlled trial.
Reginster, Jean-Yves ULg; Badurski, J; Bellamy, N et al

in Annals of the Rheumatic Diseases (2013), 72(2), 179-86

BACKGROUND: Strontium ranelate is currently used for osteoporosis. The international, double-blind, randomised, placebo-controlled Strontium ranelate Efficacy in Knee OsteoarthrItis triAl evaluated its ... [more ▼]

BACKGROUND: Strontium ranelate is currently used for osteoporosis. The international, double-blind, randomised, placebo-controlled Strontium ranelate Efficacy in Knee OsteoarthrItis triAl evaluated its effect on radiological progression of knee osteoarthritis. METHODS: Patients with knee osteoarthritis (Kellgren and Lawrence grade 2 or 3, and joint space width (JSW) 2.5-5 mm) were randomly allocated to strontium ranelate 1 g/day (n=558), 2 g/day (n=566) or placebo (n=559). The primary endpoint was radiographical change in JSW (medial tibiofemoral compartment) over 3 years versus placebo. Secondary endpoints included radiological progression, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and knee pain. The trial is registered (ISRCTN41323372). RESULTS: The intention-to-treat population included 1371 patients. Treatment with strontium ranelate was associated with smaller degradations in JSW than placebo (1 g/day: -0.23 (SD 0.56) mm; 2 g/day: -0.27 (SD 0.63) mm; placebo: -0.37 (SD 0.59) mm); treatment-placebo differences were 0.14 (SE 0.04), 95% CI 0.05 to 0.23, p<0.001 for 1 g/day and 0.10 (SE 0.04), 95% CI 0.02 to 0.19, p=0.018 for 2 g/day. Fewer radiological progressors were observed with strontium ranelate (p<0.001 and p=0.012 for 1 and 2 g/day). There were greater reductions in total WOMAC score (p=0.045), pain subscore (p=0.028), physical function subscore (p=0.099) and knee pain (p=0.065) with strontium ranelate 2 g/day. Strontium ranelate was well tolerated. CONCLUSIONS: Treatment with strontium ranelate 1 and 2 g/day is associated with a significant effect on structure in patients with knee osteoarthritis, and a beneficial effect on symptoms for strontium ranelate 2 g/day. [less ▲]

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See detailHealth economics in the field of osteoarthritis: An Expert's consensus paper from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO).
Hiligsmann, Mickaël ULg; Cooper, Cyrus; Arden, Nigel et al

in Seminars in Arthritis & Rheumatism (2013), 43(3), 303-313

OBJECTIVES: There is an important need to evaluate therapeutic approaches for osteoarthritis (OA) in terms of cost-effectiveness as well as efficacy. METHODS: The ESCEO expert working group met to discuss ... [more ▼]

OBJECTIVES: There is an important need to evaluate therapeutic approaches for osteoarthritis (OA) in terms of cost-effectiveness as well as efficacy. METHODS: The ESCEO expert working group met to discuss the epidemiological and economic evidence that justifies the increasing concern of the impact of this disease and reviewed the current state-of-the-art in health economic studies in this field. RESULTS: OA is a debilitating disease; it is increasing in frequency and is associated with a substantial and growing burden on society, in terms of both burden of illness and cost of illness. Economic evaluations in this field are relatively rare, and those that do exist, show considerable heterogeneity of methodological approach (such as indicated population, comparator, decision context and perspective, time horizon, modeling and outcome measures used). This heterogeneity makes comparisons between studies problematic. CONCLUSIONS: Better adherence to guidelines for economic evaluations is needed. There was strong support for the definition of a reference case and for what might constitute "standard optimal care" in terms of best clinical practice, for the control arms of interventional studies. [less ▲]

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See detailChanges in Structure and Symptoms in Knee Osteoarthritis and Prediction of Future Knee Replacement Over 8 Years.
Bruyère, Olivier ULg; Cooper, Cyrus; Pavelka, Karel et al

in Calcified Tissue International (2013), 93

The objective of this study was to assess the association between changes in joint space width (JSW, i.e., structure) or Western Ontario and McMaster Universities (WOMAC) score (i.e., symptoms) over 3 ... [more ▼]

The objective of this study was to assess the association between changes in joint space width (JSW, i.e., structure) or Western Ontario and McMaster Universities (WOMAC) score (i.e., symptoms) over 3 years in patients with knee osteoarthritis and the occurrence of knee replacement over 8 years. We followed 133 subjects with primary knee osteoarthritis prospectively for a mean of 8 years. JSW (standard radiography) and symptoms (total WOMAC score) were assessed every year for 3 years. The rate of knee replacement was recorded for the following 5 years. Logistic regressions were performed according to the intention-to-treat principle. After 8 years' follow-up, ten patients (7.5 %) had undergone a knee replacement. The changes in JSW or WOMAC score over 3 years were significantly associated with the occurrence of knee replacement during the following 5 years (p = 0.02 and p = 0.03, respectively). Each 0.1-mm narrowing of JSW over 3 years was associated with a 14 % (95 % CI 3-25 %) increased risk for knee replacement. For every 10 % increase in WOMAC score, the risk for joint replacement was increased by 16 % (95 % CI 1-33 %). When JSW and WOMAC score were included in the same statistical model, they were still significantly associated with risk for knee replacement (p = 0.02 and p = 0.03, respectively), but JSW change was the only variable that remained significant after adjusting for all potential confounders. Our results suggest that changes in symptoms and, more particularly, in structure over 3 years in patients with osteoarthritis reflect a clinically relevant progression of the disease. [less ▲]

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See detailDéveloppement et validation de la version française d'un questionnaire traitant des attentes des patients dans l'arthrose des membres inférieurs
NEUPREZ, Audrey ULg; Delcour, JP; Fatemi, F et al

in Revue du Rhumatisme (2013), 80(S1), 181

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See detailInhibition de la sclérostine par le romosozumab chez des femmes ménopausées ayant une DMO basse : résultats de l'étude de phase 2
Brown, JP; McClung, MR; Grauer, A et al

in Revue du Rhumatisme (2013), 80(S1), 73

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See detailLe ranélate de strontium diminue la proportion de patients progressant rapidement dès la première année : une analyse post hoc de l'étude SEKOIA
Chevalier, X; Richette, P; Bruyère, Olivier ULg et al

in Revue du Rhumatisme (2013), 80(S1), 59-60

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See detailPrevalence of vitamin D inadequacy in European postmenopausal women aged over 80 years
Bruyère, Olivier ULg; Slomian, Justine ULg; Beaudart, Charlotte ULg et al

in European Geriatric Medicine (2013), 4(S1), 13-14

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See detailOsteoporosis in the European Union : a compendium of country-specific reports
Svedbom, A; Hernlund, E; Ivergard, M et al

in Archives of Osteoporosis (2013), 8(137), 1-218

This report describes epidemiology, burden, and treatment of osteoporosis in each of the 27 countries of the European Union (EU27). INTRODUCTION: In 2010, 22 million women and 5.5 million men were ... [more ▼]

This report describes epidemiology, burden, and treatment of osteoporosis in each of the 27 countries of the European Union (EU27). INTRODUCTION: In 2010, 22 million women and 5.5 million men were estimated to have osteoporosis in the EU; and 3.5 million new fragility fractures were sustained, comprising 620,000 hip fractures, 520,000 vertebral fractures, 560,000 forearm fractures and 1,800,000 other fractures. The economic burden of incident and prior fragility fractures was estimated at euro 37 billion. Previous and incident fractures also accounted for 1,180,000 quality-adjusted life years lost during 2010. The costs are expected to increase by 25 % in 2025. The majority of individuals who have sustained an osteoporosis-related fracture or who are at high risk of fracture are untreated and the number of patients on treatment is declining. The aim of this report was to characterize the burden of osteoporosis in each of the EU27 countries in 2010 and beyond. METHODS: The data on fracture incidence and costs of fractures in the EU27 were taken from a concurrent publication in this journal (Osteoporosis in the European Union: Medical Management, Epidemiology and Economic Burden) and country specific information extracted. RESULTS: The clinical and economic burden of osteoporotic fractures in 2010 is given for each of the 27 countries of the EU. The costs are expected to increase on average by 25 % in 2025. The majority of individuals who have sustained an osteoporosis-related fracture or who are at high risk of fracture are untreated and the number of patients on treatment is declining. CONCLUSIONS: In spite of the high cost of osteoporosis, a substantial treatment gap and projected increase of the economic burden driven by aging populations, the use of pharmacological prevention of osteoporosis has decreased in recent years, suggesting that a change in healthcare policy concerning the disease is warranted. [less ▲]

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See detailStrontium ranelate in the treatment of knee osteoarthritis: new insights and emerging clinical evidence.
REGINSTER, Jean-Yves ULg; Beaudart, Charlotte ULg; Neuprez, Audrey et al

in Therapeutic advances in musculoskeletal disease (2013), 5(5), 268-276

Osteoarthritis is a primary cause of disability and functional incapacity. Pharmacological treatment is currently limited to symptomatic management, and in advanced stages, surgery remains the only ... [more ▼]

Osteoarthritis is a primary cause of disability and functional incapacity. Pharmacological treatment is currently limited to symptomatic management, and in advanced stages, surgery remains the only solution. The therapeutic armamentarium for osteoarthritis remains poor in treatments with an effect on joint structure, that is, disease-modifying osteoarthritis drugs (DMOADs). Glucosamine sulfate and chondroitin sulfate are the only medications for which some conclusive evidence for a disease-modifying effect is available. Strontium ranelate is currently indicated for the prevention of fracture in severe osteoporosis. Its efficacy and safety as a DMOAD in knee osteoarthritis has recently been explored in the SEKOIA trial, a 3-year randomized, double-blind, placebo-controlled trial. Outpatients with knee osteoarthritis, Kellgren and Lawrence grade 2 or 3, and joint space width (JSW) of 2.5-5 mm received strontium ranelate 1 g/day (n = 558) or 2 g/day (n = 566), or placebo (n = 559). This sizable population was aged 62.9 years and had a JSW of 3.50 +/- 0.84 mm. Treatment with strontium ranelate led to significantly less progression of knee osteoarthritis: estimates for annual difference in joint space narrowing versus placebo were 0.14 mm [95% confidence interval (CI) 0.05-0.23 mm; p < 0.001] for 1 g/day and 0.10 mm (95% CI 0.02-0.19 mm; p = 0.018) for 2 g/day, with no difference between strontium ranelate groups. Radiological progression was less frequent with strontium ranelate (22% with 1 g/day and 26% with 2 g/day versus 33% with placebo, both p < 0.05), as was radioclinical progression (8% and 7% versus 12%, both p < 0.05). Symptoms also improved with strontium ranelate 2 g/day only in terms of total WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) score (p = 0.045), and its components for pain (p = 0.028) and physical function (p = 0.099). Responder analyses using a range of criteria for symptoms indicated that the effect of strontium ranelate 2 g/day on pain and physical function was clinically meaningful. Strontium ranelate was well tolerated. The observation of both structure and symptom modification with strontium ranelate 2 g/day makes SEKOIA a milestone in osteoarthritis research and treatment. [less ▲]

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See detailWhat is the predictive value of MRI for the occurrence of knee replacement surgery in knee osteoarthritis?
Pelletier, J.-P.; Cooper, C.; Peterfy, C. et al

in Annals of the Rheumatic Diseases (2013), 72(10), 1594-1604

Knee osteoarthritis is associated with structural changes in the joint. Despite its many drawbacks, radiography is the current standard for evaluating joint structure in trials of potential disease ... [more ▼]

Knee osteoarthritis is associated with structural changes in the joint. Despite its many drawbacks, radiography is the current standard for evaluating joint structure in trials of potential disease-modifying osteoarthritis drugs. MRI is a non-invasive alternative that provides comprehensive imaging of the whole joint. Frequently used MRI measurements in knee osteoarthritis are cartilage volume and thickness; others include synovitis, synovial fluid effusions, bone marrow lesions (BML) and meniscal damage. Joint replacement is considered a clinically relevant outcome in knee osteoarthritis; however, its utility in clinical trials is limited. An alternative is virtual knee replacement on the basis of symptoms and structural damage. MRI may prove to be a good alternative to radiography in definitions of knee replacement. One of the MRI parameters that predicts knee replacement is medial compartment cartilage volume/thickness, which correlates with radiographic joint space width, is sensitive to change, and predicts outcomes in a continuous manner. Other MRI parameters include BML and meniscal lesions. MRI appears to be a viable alternative to radiography for the evaluation of structural changes in knee osteoarthritis and prediction of joint replacement. [less ▲]

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See detailValue of biomarkers in osteoarthritis: current status and perspectives.
Lotz, M.; Martel-Pelletier, J.; Christiansen, C. et al

in Annals of the Rheumatic Diseases (2013), 72

Osteoarthritis affects the whole joint structure with progressive changes in cartilage, menisci, ligaments and subchondral bone, and synovial inflammation. Biomarkers are being developed to quantify joint ... [more ▼]

Osteoarthritis affects the whole joint structure with progressive changes in cartilage, menisci, ligaments and subchondral bone, and synovial inflammation. Biomarkers are being developed to quantify joint remodelling and disease progression. This article was prepared following a working meeting of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis convened to discuss the value of biochemical markers of matrix metabolism in drug development in osteoarthritis. The best candidates are generally molecules or molecular fragments present in cartilage, bone or synovium and may be specific to one type of joint tissue or common to them all. Many currently investigated biomarkers are associated with collagen metabolism in cartilage or bone, or aggrecan metabolism in cartilage. Other biomarkers are related to non-collagenous proteins, inflammation and/or fibrosis. Biomarkers in osteoarthritis can be categorised using the burden of disease, investigative, prognostic, efficacy of intervention, diagnostic and safety classification. There are a number of promising candidates, notably urinary C-terminal telopeptide of collagen type II and serum cartilage oligomeric protein, although none is sufficiently discriminating to differentiate between individual patients and controls (diagnostic) or between patients with different disease severities (burden of disease), predict prognosis in individuals with or without osteoarthritis (prognostic) or perform so consistently that it could function as a surrogate outcome in clinical trials (efficacy of intervention). Future avenues for research include exploration of underlying mechanisms of disease and development of new biomarkers; technological development; the 'omics' (genomics, metabolomics, proteomics and lipidomics); design of aggregate scores combining a panel of biomarkers and/or imaging markers into single diagnostic algorithms; and investigation into the relationship between biomarkers and prognosis. [less ▲]

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