| Title: |
How are patient-reported pain outcomes associated with biomarker and structural pathology subtypes in knee osteoarthritis? An explorative evaluation in the IMI-APPROACH cohort |
| Authors: |
Jansen, M. P.; Mastbergen, S. C.; Wirth,W.; Roemer,F. W.; Bacardit,J.; Bay-Jensen,A. C.; Kloppenburg,M.; Blanco,F. J.; Haugen,I. K.; Berenbaum,F.; Eijkelkamp, N.; Jarraya,M.; Lab Reumatologie/Klinische Immunologie; Regenerative Medicine and Stem Cells; Infection & Immunity; MS Reumatologie/Immunologie/Infectie; CTI Eijkelkamp; Cancer; Brain; Child Health |
| Publication Year: |
2026 |
| Subject Terms: |
Biomarkers; Imaging; Neuropathic; Pain; Phenotyping; Biomedical Engineering; Orthopedics and Sports Medicine; Rehabilitation |
| Description: |
Objective: To explore associations between patient-reported pain outcomes and knee osteoarthritis (OA) subtypes based on systemic biochemical markers and joint structural pathology as defined by MRI. Methods: Data were obtained from 297 knee OA patients from the IMI-APPROACH study. Pain outcomes were assessed using the KOOS, WOMAC, ICOAP, NRS, PainDETECT, and a pain diary. Biochemical markers in serum and urine were used to classify patients into systemic biomarker subtypes (low tissue turnover, structural damage, and systemic inflammation) via k-means clustering. Structural pathology subtypes were determined using MRI into an inflammatory, meniscus/cartilage damage, and subchondral bone pathology subtype. Associations between pain measures and subtypes were analyzed using multivariable regression models adjusted for age, sex, and BMI. Results: The systemic inflammation biomarker subtype was significantly associated with higher KOOS pain, WOMAC weight-bearing pain, NRS knee pain, and PainDETECT scores (all p ≤ 0.042 and β ≥ 0.12). The low tissue turnover subtype negatively associated with lower KOOS, WOMAC, and ICOAP constant pain (all p ≤ 0.22 and β ≤ −0.13), and the structural damage subtype with lower PainDETECT scores (more nociceptive-like pain; p = 0.046 and β = −0.12). Among MRI subtypes, meniscus/cartilage damage was significantly associated with lower PainDETECT scores (p = 0.005 and β = −0.16). No significant associations were found for the subchondral bone subtype or pain diary outcomes. Conclusion: For commonly used pain questionnaires, pain severity seems linked with inflammatory activity more than structural damage. Structural damage is primarily associated with nociceptive-like pain according to PainDETECT, which might be valuable for patient selection to clinical trials and observational studies. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| ISSN: |
2665-9131 |
| Relation: |
https://dspace.library.uu.nl/handle/1874/468951 |
| Availability: |
https://dspace.library.uu.nl/handle/1874/468951 |
| Rights: |
info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.761C4E71 |
| Database: |
BASE |