Bisphosphonate intake and tibiofemoral osteoarthritis-related osseous structural damage: data from the foundation for the National Institute of Health Osteoarthritis Biomarkers Consortium

Abstract

Purpose: To determine whether bisphosphonate intake was associated with a protective effect on tibiofemoral osteoarthritis (OA) progression. Methods: We analyzed data from female subjects (one index knee) from the Foundation for the National Institute of Health (FNIH) study. Subjects were classified as bisphosphonate users (n = 56) and non-users (n = 295). The association between bisphosphonate intake and OA-related radiographic joint space loss (JSL) progression (>0.7 mm; using 24-48months follow-up radiographs) and osseous damage worsening (baseline-24months MRI OA Knee Score (MOAKS) changes for bone marrow lesion (BML) and osteophyte) was evaluated using logistic regression. Re-analysis using propensity score matching was performed to address confounding by indication for bisphosphonate intake. The sub-group analysis was performed for the role of BML and osteophyte in modulating bisphosphonates' effects on JSL progression. To determine which types of OA subjects may benefit from bisphosphonate, subjects were classified based on the baseline radiographic/MRI characteristics, and analyses were performed in each category. Results: JSL progression (odds ratio 95% confidence interval (OR (95% CI)): 0.364 (0.183-0.721), P:0.004) and BML worsening (OR (95% CI): 0.342 (0.124–0.946), P:0.039) were lower in bisphosphonate users compared to non-users, independent of risk factors for osteoporosis and OA. Using propensity score matching, the above results were confirmed for JSL progression (OR (95% CI): 0.443 (0.203–0.964), P:0.040) and BML worsening (OR (95% CI): 0.315 (0.110–0.904), P:0.032). No significant differences detected between BML/osteophyte worsening and non-worsening sub-groups. No difference was detected for effect of bisphosphonate between knees with different baseline radiographic OA grade, BML, and osteophyte scores. Conclusions: Bisphosphonate intake may exhibit protective effects on OA-related tibiofemoral radiographic progression and osseous structural damage worsening.