Background The diagnosis of osteoarthritis is currently based on radiographic criteria (eg, joint space width) and clinical symptoms (eg, pain and loss of function).
The evaluation of new disease-modifying osteoarthritis drugs (DMOADs) is performed on the same basis, since the regulatory bodies currently require evidence for an impact on radiographic joint space narrowing (JSN) and an impact on symptoms However, the limitations of radiography have led to research into alternative parameters for monitoring osteoarthritis that could serve as biomarkers in drug development.
Objectives Detection the serum level of MMP-13 and IL-1 β In OA of the knee during remission and exacerbation and if these Biomarkers can be validated as gold biomarkers in assessing OA progression and drug development in OA treatment.
Methods This study was performed on 60 patients with knee osteoarthritis, 18 males (30%) and 42 females (70%), all diagnosed as osteoarthritis of one or both knees. Their ages ranged from (40 -65) years. The duration of their disease ranged from one to 15years. The control groups were 8 males (32%) and 17 females (68%). their ages ranged from (40–65) years.
The patients were allowed to continue on the medications that they have pro inflammatory cytokines (IL-1β) and degradative enzymes (MMP-13) are measured.
Clinical assessing for pain using visual analogue scale (0–10)
Assessing for pain, stiffness and physical functions by:
(A) the WOMAC osteoarthritis index
(B) Lequesne's algo functional index
Asssesing the flare-ups using Knee Osteoarthritis Flare Ups Score (KOFUS).
Results Patients who had 3 flare-ups (during one year follow up) showed the statistically significantly highest mean IL-1β & MMP13 level.
There was no statistically significant difference between patients with no flare-up, 1 flare-up and 2 flare-ups; all showed statistically significantly lower mean levels.
There was a statistically significant positive (direct) correlation between IL-1β, disease duration, KL, VAS, stiffness score, pain score, functional score, WOMAC and KOFUS. An increase in all these variables is associated with an increase in IL-1β & MMP13.
There is a potential role for IL1 beta and MMP 13 biomarkers in assessing the development in osteoarthritis.
IL 1 β and MMP 13 were founded to be correlated positively in patients with knee OA this correlation sounded right as the expression of MMP 13 depends on the level of IL1 β.
Although all medications groups failed to lower the level of IL 1 β and MMP 13,yet there was a numerical difference in favor of Diacerine and NSAID.
patients on both Diacerine and NSAID had the lowerest rate of flare ups
It is recommended that the early measurement of biomarkers may detect cases to progress and thus stronger treatment may be given for these groups.
Disclosure of Interest None declared