Symptomatic knee osteoarthritis has an incidence of 240/100,000 person years and is one of the most frequent causes of dependency in lower limb tasks, especially in the elderly. It causes 68 million work loss days per year and more than 5% of the annual retirement rate. Osteoarthritis is the most frequent reason for joint replacement at a cost to the community of billions of dollars per year. No effective medical remedies for osteoarthritis currently exist. However, the pharmaceutical industry is attempting to develop drugs that retard progression of OA. If efficacious, these proprietary medications will be expensive to employ in a population in which OA is endemic. Ironically, there is evidence that vit D supplementation, a simple non-proprietary intervention, may have efficacy in slowing progression of OA. Even if only moderately effective, it could have considerable impact in terms of reducing the societal impacts of OA. Therefore, in the interests of public health, the efficacy of vit D supplementation as a disease-modifying treatment for OA needs to be tested in a rigorous clinical trial. Disease-modification trials for knee OA have been difficult due to limitations of the radiographic technique. However, MRI has emerged as a valid, precise and reproducible tool for obtaining volumetric measures of cartilage and joint structures. Our goal is to enroll 140 individuals with symptomatic knee OA into a 2-year randomized placebo-controlled clinical trial of vit D, 14,000 IU/week. Outcomes will include the WOMAC questionnaire (primary clinical), cartilage volume loss (primary pathological), physical function tests, SF-36 and whole-organ knee MRI OA severity scores. Bone density, calcium homeostasis and knee alignment will be tested as intermediary variables. We will test effectiveness of vit D using cross- sectional time series regression models with first-order autoregressive disturbance adjusting for informative dropouts.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
James A. Shannon Director's Award (R55)
Project #
1R55AR051361-01
Application #
6811437
Study Section
Special Emphasis Panel (ZRG1-RUS-D (03))
Program Officer
Lester, Gayle E
Project Start
2004-09-01
Project End
2006-08-31
Budget Start
2004-09-01
Budget End
2006-08-31
Support Year
1
Fiscal Year
2004
Total Cost
$100,000
Indirect Cost
Name
Tufts University
Department
Type
DUNS #
079532263
City
Boston
State
MA
Country
United States
Zip Code
02111