A systematic review of the relationship between subchondral bone features, pain and structural pathology in peripheral joint osteoarthritis

Introduction: Bone is an integral part of the osteoarthritis (OA) process. We conducted a systematic literature review in order to understand the relationship between non-conventional radiographic imaging of subchondral bone, pain, structural pathology and joint replacement in peripheral joint OA. Methods: A search of the Medline, EMBASE and Cochrane library databases was performed for original articles reporting association between non-conventional radiographic imaging-assessed subchondral bone pathologies and joint replacement, pain or structural progression in knee, hip, hand, ankle and foot OA. Each association was qualitatively characterised by a synthesis of the data from each analysis based upon study design, adequacy of covariate adjustment and quality scoring. Results: In total 2456 abstracts were screened and 139 papers were included (70 cross-sectional, 71 longitudinal analyses; 116 knee, 15 hip, six hand, two ankle and involved 113 MRI, eight DXA, four CT, eight scintigraphic and eight 2D shape analyses). BMLs, osteophytes and bone shape were independently associated with structural progression or joint replacement. BMLs and bone shape were independently associated with longitudinal change in pain and incident frequent knee pain respectively. Conclusion: Subchondral bone features have independent associations with structural progression, pain and joint replacement in peripheral OA in the hip and hand but especially in the knee. For peripheral OA sites other than the knee, there are fewer associations and independent associations of bone pathologies with these important OA outcomes which may reflect fewer studies; for example the foot and ankle were poorly studied. Subchondral OA bone appears to be a relevant therapeutic target. Systematic review: PROSPERO registration number: CRD 4201300500

Health-related quality-of-life in patients with cholangiocarcinoma: Results of a systematic literature review.

e15623 Background: Cholangiocarcinoma (CCA) is a rare biliary tract cancer (BTC) with a historically poor prognosis and limited treatment options. Both quality and quantity of life can be important factors when deciding treatment, thus assessment of health-related quality-of-life (HRQoL) is needed to justify the use of novel therapies. HRQoL questionnaires are a standardized way to understand the patients’ perspective and treatment experience. The objective of this review was to examine the published literature specific to HRQoL in CCA. Methods: A systematic literature search was conducted using EMBASE and MEDLINE from Jan 2008 to June 2018 to identify abstracts with published HRQoL data in CCA patients. This review also included global conference proceedings (2015-2018) and HTA websites. Articles were considered relevant if they reported HRQoL data in patients with CCA, bile duct carcinoma, and/or hepatobiliary system cancer. Results: Of the 2,933 studies initially identified, 7 ongoing or completed studies met the scoping criteria to be included in the review. No articles in this literature review reported data from clinical trials. Multiple HRQoL measures were utilized; however within the studies, EORTC QLQ-BIL21 was the only HRQoL measure developed and validated specifically for BTC (CCA, gallbladder, or ampulla vater) identified in this review. 3/7 studies included information on CCA subtypes (intrahepatic, extrahepatic) with 2/3 studies reporting HRQoL by subtype. Patient symptoms were reported in 4/7 studies, including gastrointestinal distress, abdominal pain, fatigue, fever, itching, difficulty sleeping, anxiety, jaundice and weight loss. Conclusions: Within this literature review, few studies have been published with HRQoL data in CCA patients. Data from the existing published literature is generally from a heterogeneous patient population, and not consistently specified for CCA stage or subtype. To better understand HRQoL in CCA patients, more data needs to be generated that include clinical trials for novel therapies. </jats:p

Additional file 1: of A systematic review of the relationship between subchondral bone features, pain and structural pathology in peripheral joint osteoarthritis

Supplementary material: supplementary methods and results. (DOC 1659 kb