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: 2207

Urine CTX-II, CTX-I, Osteocalcin, and Radiographic Severity of Multiple OA Knee Joints: Does CTX-II Originate from Bone or Cartilage?

Asger R. Bihlet1, Inger Byrjalsen2, Anne C. Bay-Jensen3, Jeppe Andersen4, Claus Christiansen1, Bente J. Riis1 and Morten Asser Karsdal3, 1Nordic Bioscience, Clinical Development, Herlev, Denmark, 2Nordic Bioscience, Herlev, Denmark, 3Rheumatology, Nordic Bioscience, Herlev, Denmark, 4Clinical Development, Nordic Bioscience, Herlev, Denmark

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: Biomarkers, Bone, cartilage and osteoarthritis

  • Tweet
  • Email
  • Print
Session Information

Date: Tuesday, November 7, 2017

Title: Osteoarthritis – Clinical Aspects Poster II: Observational and Epidemiological Studies

Session Type: ACR Poster Session C

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

Background/Purpose: Excessive cartilage degradation is a known characteristic of osteoarthritis (OA), and several methods of quantification of cartilage degradation exist. Biomarkers such as urinary C-telopeptide fragments resulting from inflammatory destruction of collagen type II (uCTX-II) have been shown to be associated with disease severity and pain in OA, yet the tissue-origin of uCTX-II has been disputed.

The purpose of this analysis was to investigate the potential association between OA in single and multiple joints at different radiographic stages on circulating levels of uCTX-II and biomarkers of bone resorption and bone formation; serum and urine C-telopeptide of collagen type I, CTX-I, and serum osteocalcin, respectively.

Methods: Pooled, pre-treatment baseline data of two phase III randomized clinical trials (NCT00486434 and NCT00704847) in patients with radiographic OA of at least one knee joint were analyzed post-hoc. Key inclusion criteria were knee OA with a Kellgren and Lawrence (KL) score of 2 or 3, and pain of at least 150 mm out of 500 mm using the WOMAC pain subscore, of at least one knee.  A subgroup with available urine samples (N=1200) was analyzed for this report. Baseline levels of serum and urine CTX-I, urine CTX-II and serum osteocalcin were analysed using validated enzyme-linked immunosorbent assays and analyzed for associations with combined KL-scores for both knees, and cumulative KL-scores to assess the individual biomarker contribution of joints at different disease stages using multiple pairwise comparisons. KL score of 0 was defined as absence of OA, while all knees with KL scores of ≥ 1 were defined as OA joints.

Results: Unilateral knee OA was present in 4.1 % of patients in the study. 63.1 % of patients had bilateral, early OA, 10.1 % had bilateral late OA, and 22.0 % had bilateral OA of mixed stages. No patients had unilateral OA with late stage disease. Patients with bilateral, late-stage OA had significantly higher levels of uCTX-II compared to patients with earlier OA. The presence of at least one KL-4 joint appeared to markedly increase the level of CTX-II regardless of the KL-score of the contralateral knee joint. Levels of CTX-I and osteocalcin were not significantly different between KL-grades.

Conclusion: These results confirm that levels of uCTX-II are associated with radiographic severity of OA, while biomarkers of bone turnover was not. Multiple joints appear to contribute to uCTX-II levels in an incremental manner according to radiographic severity of individual joints.

Figure 1

Association between geometric mean concentration of uCTX-II, sCTX-I and osteocalcin and Kellgren-Lawrence radiographic stage in the knees of 1200 OA patients. Asterisks indicate statistically significant (p<0.05) difference to the group of subjects with the lowest cumulative KL-score, i.e. a KL-grade of 0 in one knee and 2 in the other (“0-2”).


Disclosure: A. R. Bihlet, Nordic Bioscience Diagnostic, 3; I. Byrjalsen, Nordic Bioscience Diagnostic, 3; A. C. Bay-Jensen, Nordic Bioscience Diagnostic, 3; J. Andersen, Nordic Bioscience Diagnostic, 3; C. Christiansen, Nordic Bioscience Diagnostic, 3; B. J. Riis, Nordic Bioscience Diagnostic, 3; M. A. Karsdal, Nordic Bioscience Diagnostic, 3.

To cite this abstract in AMA style:

Bihlet AR, Byrjalsen I, Bay-Jensen AC, Andersen J, Christiansen C, Riis BJ, Karsdal MA. Urine CTX-II, CTX-I, Osteocalcin, and Radiographic Severity of Multiple OA Knee Joints: Does CTX-II Originate from Bone or Cartilage? [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/urine-ctx-ii-ctx-i-osteocalcin-and-radiographic-severity-of-multiple-oa-knee-joints-does-ctx-ii-originate-from-bone-or-cartilage/. Accessed .
  • Tweet
  • Email
  • Print

« Back to 2017 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/urine-ctx-ii-ctx-i-osteocalcin-and-radiographic-severity-of-multiple-oa-knee-joints-does-ctx-ii-originate-from-bone-or-cartilage/

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