[How to evaluate the long-term course of osteoarthritis. Tests for trials of fundamental treatments (spine excluded)].
The best assessment tests for long term trials on osteoarthritis (OA) of the hip and knee are the following, in order of relevance value (consensus of french experts): 1) the loss of joint space thickness on successive radiographies; 2, 3) the indices of the severity for OA of the hip and knee; the investigator's overall opinion; 4) the patient's overall opinion (visual analogue scale of handicap); 5, 6, 7) the pain level (visual analogue scale); the time for going up and down a standard flight of stairs and the time of pain in this distance; the limitation of two articular movements; 8) the increase of either analgesics or NSAIDs consumption; 9) concerning OA of fingers, the number of joints newly involved on successive radiographies. At present, only the radiological tests 1 and 9 are validated. The clinical tests 2 to 8, valuable for short term trials, have yet to be validated for long term follow-up. Recommended duration of trials is three years. A rigorous organisation is necessary to avoid erroneous inclusions: all data recorded in the pre-inclusion visit have to be checked by the principal investigator. Since we have not yet a validated chondroprotective agent as a reference drug, the trial must be randomised, double blind, placebo controlled, parallel group study.
Lequesne
M
M
Service de Rhumatologie, Hôpital Léopold-Bellan, Paris.
Dougados
M
M
Abiteboul
M
M
Bontoux
D
D
Bouvenot
G
G
Chicheportiche
V
V
Dreiser
R L
RL
Dropsy
R
R
Maheu
E
E
Mazières
B
B
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002357:Cartilage Diseases / Q000188:drug therapy; D002986:Clinical Trials as Topic / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010147:Pain Measurement; D011859:Radiography; D012720:Severity of Illness Index; D013997:Time Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal
Comment évaluer l'évolution de l'arthrose à long terme. Tests pour les essais de traitements de fond (rachis exclu).