Background/Purpose: There is an obvious need to identify biomarkers that could predict patient response to an osteoarthritis (OA) treatment. This post hoc study explored in a 2-year randomized controlled trial in knee OA patients, the likelihood of some serum biomarkers to be associated with a better response to chondroitin sulfate at reducing cartilage volume loss.

Methods: Eight biomarkers were studied: hyaluronic acid (HA), C reactive protein (CRP), adipsin, leptin, N-terminal propeptide of collagen IIα (PIIANP), C-terminal crosslinked telopeptide of type I collagen (CTX-1), matrix metalloproteinase-1 (MMP-1), and MMP-3. Patients were treated with chondroitin sulfate (1200 mg/day; n=57) or celecoxib (200 mg/day; n=62). Serum biomarkers were measured at baseline. The cartilage volume at baseline and its loss at 2 years was assessed by quantitative magnetic resonance imaging (MRI). Statistical analysis included ANCOVA.

Results: As data from the original MOSAIC trial showed no differences in the lateral compartment between the two treatment groups in cartilage volume and loss in any comparison, only the medial compartment and its subregions were studied. Stratification according to the median biomarker levels was used to discriminate treatment effect. In patients with levels of biomarkers of inflammation (HA, leptin and adipsin) lower than the median, those treated with chondroitin sulfate demonstrated less cartilage volume loss in the medial compartment, condyle and plateau (p≤0.047). In contrast, chondroitin sulfate treated patients with higher levels of MMP-1 and MMP-3, biomarkers of cartilage catabolism, had less cartilage volume loss in the medial compartment, condyle and plateau (p≤0.050). Patients with higher levels of PIIANP and CTX-1, biomarkers related to collagen anabolism and bone catabolism, respectively, had reduced cartilage volume loss in the medial condyle (p≤0.026) in the chondroitin sulfate group.

Conclusion: This study provides important and novel information about the association of some serum biomarker levels with cartilage degradation, which could help to identify patients who are most likely to be responsive to a treatment. Moreover, data are suggestive of a potentially greater response to chondroitin sulfate treatment on cartilage volume loss in knee OA patients with low level of inflammation and/or greater level of cartilage catabolism.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/levels-of-serum-biomarkers-from-a-two-year-multicentre-trial-are-associated-with-treatment-response-on-knee-osteoarthritis-cartilage-loss-as-assessed-by-mri-an-exploratory-study/