ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 1123

The Patient Journey in Knee OA: Variations in Patient Characteristics and Treatment by Physician Specialty

Angela Bedenbaugh1, Vinson Lee1, Gary Oderda2, Sarah Kennedy1, Diana Brixner2, Jeyanesh Tambiah3 and Timothy McAlindon4, 1Samumed, LLC, San Diego, CA, 2University of Utah, Salt Lake City, UT, 3Samumed LLC, San Diego, CA, 4Tufts Medical Center, Boston, MA

Meeting: ACR Convergence 2020

Keywords: Epidemiology, Osteoarthritis, practice guidelines, Total joint replacement

  • Tweet
  • Email
  • Print
Session Information

Date: Sunday, November 8, 2020

Title: Osteoarthritis – Clinical Poster I

Session Type: Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Knee osteoarthritis (OA) affects 32.5 million US adults and is typically treated by primary care physicians, rheumatologists (RH), orthopedists (OS), sports medicine (SM) physicians, and pain specialists (PS). Treatment is multimodal and comprises conservative and pharmacological therapies, intra-articular injections, and surgery. Guidelines provide recommendations in idealized settings, but little documentation exists in real world settings; hence, we aimed to assess patient characteristics and treatment patterns across 4 specialties.

Methods: This project was exempt from IRB review and HIPAA consent. Physicians with >2 years in practice and >10 knee OA patients per week were interviewed about their 2 most recent knee OA patients. Interviews (structured questions and answers) assessed demographics, referrals, comorbidities, time to treatment, and lines of therapy. As this study was designed to assess effect modifications, a confidence level of 90% was used.

Results: Patient demographics are shown in Table 1. Participating physicians included 125 RH, 176 OS, 76 SM, and 50 PS. Overall, 854 patients were included in the chart review. Patients were mean age 65 years, mean BMI 30.7, and 51% were female. First-line treatments are shown in Figure 1. Mean time between symptom onset and diagnosis was 3.4 years. Over 90% of patients used over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen (APAP), with lowest use in RH patients. IA corticosteroids (CS) were used in ~20% of patients and hyaluronic acid (HA) in ~10% of patients, with similar use across specialties. Reasons for therapy discontinuation (DC) included lack of efficacy, AE/safety, and formulary/cost (Table 2). DC for lack of efficacy was 61% for single-injection HA. AE/safety concerns were reasons for DC of prescription (Rx) NSAIDs and opioids. Second-line treatments included CS >OTC Rx NSAIDs/APAP >HA. Third-line treatments were HA >CS >OTC Rx NSAIDs/APAP. Mean BMI was significantly higher in SM (33) and PS (32) patients compared with OS (30) and RH (30) patients. There were significantly more female RH patients (56%) than OS patients (47%). PS patients had significantly higher current unemployment (73%) due to an inability to perform function (15%) than patients treated by other specialties. RH, SM, and PS patients had significantly more comorbidities than OS patients. Overall, mean pain (NRS 0–10) was 5.6 and KL grade was 3. PS patients had significantly higher pain scores (6.5) than patients treated by other specialties. Limitations included selection bias, confounding, small N, and missing data.

Conclusion: PS see more patients with pain syndromes and higher BMIs. RH see more patients with rheumatoid conditions. OS patients used significantly more OTC NSAIDs/APAP than RH patients and were less likely than SM and PS patients to use Rx NSAIDs. Lack of efficacy drove most therapy changes. Of HA patients, 61% discontinued due to lack of efficacy. These data suggested that treatment patterns for knee OA were similar across physician types, and new therapies can provide additional options to currently available treatments that may have efficacy or safety concerns.


Disclosure: A. Bedenbaugh, Samumed, 3; V. Lee, Samumed, 5; G. Oderda, Samumed, LLC, 5; S. Kennedy, Samumed, LLC, 1, 3; D. Brixner, Samumed, 5; J. Tambiah, Samumed, LLC, 1, 3; T. McAlindon, Pfizer, 1, Sanofi Aventis US, 1, Kolon Tissuegene, 1, Samumed, 1, Seikagaku, 1, Kiniksa Pharmaceuticals, 1, Anika Therapeutics, 1.

To cite this abstract in AMA style:

Bedenbaugh A, Lee V, Oderda G, Kennedy S, Brixner D, Tambiah J, McAlindon T. The Patient Journey in Knee OA: Variations in Patient Characteristics and Treatment by Physician Specialty [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/the-patient-journey-in-knee-oa-variations-in-patient-characteristics-and-treatment-by-physician-specialty/. Accessed .
  • Tweet
  • Email
  • Print

« Back to ACR Convergence 2020

ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-patient-journey-in-knee-oa-variations-in-patient-characteristics-and-treatment-by-physician-specialty/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology