P.G. Conaghan, MB BS, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds, UK.
R.H. Dworkin, PhD, University of Rochester, Rochester, New York, USA.
J Rheumatol. 2022 Jun;49(6):615-621. doi: 10.3899/jrheum.210543. Epub 2022 Mar 1.
To define meaningful within-patient change (MWPC) in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).
Data were analyzed separately from 3 phase III clinical trials (ClinicalTrials.gov: NCT02697773, NCT02709486, NCT02528188) of tanezumab, a novel treatment intended for the relief of signs and symptoms of moderate-to-severe osteoarthritis (OA), administered subcutaneously every 8 weeks. Patients with moderate-to-severe OA of the hip or knee completed the WOMAC and patient global assessment of OA (PGA-OA) at regular timepoints. A repeated measures longitudinal model with change in WOMAC Pain, Physical Function, or Stiffness domain score as the outcome and change in PGA-OA as the anchor was used to establish MWPC for WOMAC domains.
In the 3 studies, there were 688, 844, and 2948 subjects available for analyses, respectively. Analysis showed that a linear relationship between changes in WOMAC domains and changes in PGA-OA was supported and justified. Moreover, the relationships between these changes were very similar for 2 trials and close for the third. The estimated MWPC for the 3 WOMAC domains were from 0.84-1.16 (0-10 numerical rating scale) and from 12.50-16.23%, depending on study and domain, that corresponded to a 1-category change on PGA-OA. For a 2-category change those values were from 1.68-2.31 and from 25.01-32.46%, respectively.
These results establish MWPCs for WOMAC domains, at the individual patient level, for patients with moderate-to-severe OA of the hip or knee. [ClinicalTrials.gov: NCT02697773, NCT02709486, and NCT02528188].
定义西部安大略省和麦克马斯特大学骨关节炎指数(WOMAC)中的有意义的患者内变化(MWPC)。
分别对 3 项 III 期临床试验(ClinicalTrials.gov:NCT02697773、NCT02709486、NCT02528188)的数据进行了分析,这些试验均为一种新型治疗药物 tanezumab 的研究,用于缓解中度至重度骨关节炎(OA)的体征和症状,每 8 周皮下给药一次。中度至重度髋或膝关节 OA 患者定期完成 WOMAC 和患者 OA 总体评估(PGA-OA)。使用重复测量纵向模型,将 WOMAC 疼痛、身体功能或僵硬域评分的变化作为结果,PGA-OA 的变化作为锚点,建立 WOMAC 域的 MWPC。
在 3 项研究中,分别有 688、844 和 2948 名受试者可用于分析。分析表明,WOMAC 域变化与 PGA-OA 变化之间的线性关系得到了支持和证实。此外,前两项试验之间的这些变化关系非常相似,而第三个试验则非常接近。3 项 WOMAC 域的估计 MWPC 范围为 0.84-1.16(0-10 数字评分量表)和 12.50-16.23%,具体取决于研究和域,相当于 PGA-OA 上的 1 个类别变化。对于 2 个类别变化,这些值分别为 1.68-2.31 和 25.01-32.46%。
这些结果为髋或膝关节中度至重度 OA 患者建立了 WOMAC 域的 MWPC,以个体患者为单位。[ClinicalTrials.gov:NCT02697773、NCT02709486 和 NCT02528188]。