Member Update: EsSKOA Initiative

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Early-stage Symptomatic Knee Osteoarthritis (EsSKOA) Initiative

In 2021, OARSI launched an initiative to develop classification criteria for Early-stage Symptomatic Knee Osteoarthritis (EsSKOA). This initiative aims to provide a standardized method for identifying and enrolling individuals with symptomatic knee osteoarthritis (OA) but without established OA, i.e. EsSKOA, into clinical studies (people who are currently ineligible for OA clinical trials). The eventual classification criteria must accomplish two tasks: accurately discriminate individuals with EsSKOA from those with other causes for their knee symptoms, and from individuals with established knee OA.

This multi-phase initiative follows methodology established by the American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) for developing classification criteria, which incorporates: 1) generation of a list of candidate items that should be considered in development of the criteria; 2) data collection and analysis to examine the ability of the candidate items, individually and in combination, to discriminate people with EsSKOA from other causes of knee symptoms (differential diagnosis) and from individuals with established knee OA; 3) informed by the evidence, a consensus-based decision analysis process to identify those factors (and their relative weights) that influence the probability that the individual has EsSKOA; and finally, 4) refinement and validation. Ultimately, we want to find the most concise combination of factors that, when applied to individuals with undifferentiated knee symptoms, accurately identifies those with high probability of having EsSKOA.

EsSKOA Phases

Thank you to the industry supporters of this initiative, Grünenthal and Viatris Inc., and the fundraising efforts by Stefan Lohmander, Ali Mobasheri, and Francis Berenbaum, on behalf of OARSI. We also would like to acknowledge support from the OARSI Board of Directors.

View the list of Committee Members here.

Call to recruit volunteers for the next phase: We Need You!

Do you see people with undiagnosed knee symptoms?

  • Are you already collecting candidate items?
  • Are you available to collect candidate items?

The EsSKOA Initiative is seeking datasets for analyses. Please let us know if you have a dataset with >100 adults with knee symptoms & data on identified candidate items:

https://redcap.utoronto.ca/surveys/?s=HCKE44YAT33797HW

Member Update:

The most recent status report (September 2023) from the EsSKOA Initiative to develop Classification Criteria for early-stage symptomatic knee OA may be viewed here.

Publications

Manuscripts

  1. Mahmoudian A, King LK, Liew JW, Wang Q, Appleton CT, Englund M, Haugen IK, Lohmander LS, Runhaar J, Turkiewicz A, Neogi T, Hawker GA; OARSI Early-stage Symptomatic Knee Osteoarthritis Initiative. Timing is everything: Towards classification criteria for early-stage symptomatic knee osteoarthritis. Osteoarthritis Cartilage. 2024 Mar 2:S1063-4584(24)00928-2. doi: 10.1016/j.joca.2024.02.888.
  2. King LK, Mahmoudian A, Waugh EJ, Stanaitis I, Gomes M, Hung V, MacKay C, Liew JW, Wang Q, Turkiewicz A, Haugen IK, Appleton CT, Lohmander S, Englund M, Runhaar J, Neogi T, Hawker GA; OARSI Early-stage Symptomatic Knee Osteoarthritis Initiative. "You don't put it down to arthritis": A qualitative study of the first symptoms recalled by individuals with knee osteoarthritis. Osteoarthr Cartil Open. 2023 Dec 16;6(1):100428. doi: 10.1016/j.ocarto.2023.100428.
  3. Liew JW, King LK, Mahmoudian A, Wang Q, Atkinson HF, Flynn DB, Appleton CT, Englund M, Haugen IK, Lohmander LS, Runhaar J, Neogi T, Hawker G; OARSI Early Osteoarthritis Classification Criteria Task Force. A scoping review of how early-stage knee osteoarthritis has been defined. Osteoarthritis Cartilage. 2023 Sep;31(9):1234-1241. doi: 10.1016/j.joca.2023.04.015.

Abstracts

  1. King L, Liew J, Wang Q, Mahmoudian A, Stanaitis I, Runhaar J, Appleton CT, Turkiewicz A, Englund M, Lohmander S, Haugen IK, Neogi T, Hawker GA. Multi-centre Modified Delphi Exercise to Identify Important Candidate Items for Classifying Early-stage Symptomatic Knee Osteoarthritis. Osteoarthritis Cartilage. 2024;32(suppl 1):S260. doi: 10.1016/j.joca.2024.02.374.
  2. King L, Mahmoudian A, Liew J, Wang Q, Stanaitis I, Schiphof D, Callahan LF, Hunter D, Appleton CT, Turkiewicz A, Englund M, Lohmander S, Haugen IK, Neogi T, Hawker GA, Runhaar J. An International Patient Survey to Identify Candidate Items for Classifying Early-stage Symptomatic Knee Osteoarthritis. Osteoarthritis Cartilage. 2024;32(suppl 1):S257-8. doi: 10.1016/j.joca.2024.02.371.
  3. Liew J, King LK, Mahmoudian A, Wang Q, Flynn DB, Appleton T, Englund M, Haugen IK, Lohmander L, Runhaar J, Neogi T, Hawker G. Defining Early-Stage Knee Osteoarthritis: A Scoping Review. Osteoarthritis Cartilage. 2023;31(suppl 1):S201-S202. doi: 10.1016/j.joca.2023.01.177.
  4. King L, Mahmoudian A, Waugh E, MacKay C, Stanaitis I, Liew JW, Wang Q, Turkiewicz A, Haugen I, Appleton CT, Lohmander S, Englund M, Runhaar J, Neogi T, Hawker GA. “You Don’t Put It Down To Arthritis”: Qualitative Analysis Of The First Symptoms Recalled By Individuals With Knee Osteoarthritis. Osteoarthritis Cartilage. 2023;31 (suppl 1):S208-S209. doi: 10.1016/j.joca.2023.01.186.
  5. Mahmoudian A, King LK, Liew JW, Wang Q, Appleton CT, Englund M, Haugen IK, Lohmander LS, Runhaar J, Turkiewicz A, Neogi T, Hawker G. Candidate Items For Classifying Early-Stage Knee Osteoarthritis: Results From An International Expert Survey. Osteoarthritis Cartilage. 2023;31 (suppl 1):S215. doi: 10.1016/j.joca.2023.01.195.
  6. Liew J, King L, Mahmoudian A, Wang Q, Neogi T, Hawker G. Defining Early-stage Knee Osteoarthritis: A Scoping Review. Arthritis Rheumatol. 2022; 74 (suppl 9). https://acrabstracts.org/abstract/defining-early-stage-knee-osteoarthritis-a-scoping-review/