Precision OA

Team: Precision OA, aka the “Bayesian Ballers”

Base Article:  Jiang X, Nelson AE, Cleveland RJ, et al. Precision Medicine Approach to Develop and Internally Validate Optimal Exercise and Weight-Loss Treatments for Overweight and Obese Adults With Knee Osteoarthritis: Data From a Single-Center Randomized Trial. Arthritis Care Res (Hoboken). 2021;73(5):693-701. doi:10.1002/acr.24179

Authors: The University of North Carolina Fellowship Program

  1. Natalie Allcott, DO, first year Rheumatology fellow, UNC
  2. Pranathi Narayanareddy, MD, first year Rheumatology fellow, UNC
  3. Sahar Sawani, MD, first year Rheumatology fellow, UNC

Team Overview

In the storied arena of knee osteoarthritis (OA), precision medicine is a standout rookie, bending norms and ushering in a new era of treatment. Every athlete has their individualized training regimens. Similarly, precision medicine tailors interventions for overweight and obese adults with knee OA, recognizing that a one-size-fits-all approach will no longer score in this dynamic arena.

Researchers used data from the Intensive Diet and Exercise for Arthritis trial, where 343 participants were randomized to diet alone, exercises alone, and diet + exercise cohorts. Outcomes including SF-36 physical component score, weight loss, WOMAC pain/function/stiffness scores, compressive force, and IL-6 were evaluated. Researchers used machine learning models considering factors like genetic makeup, lifestyle, and the severity of knee OA to develop personalized treatment recommendations.

Like a synchronized point guard and small forward, the combined diet and exercise regimen emerged as the powerhouse duo for most participants across outcomes of weight loss since baseline, WOMAC pain, function, and stiffness scores, as well as PCS.  In individuals where the primary goal is to reduce systemic inflammation, diet alone was found to be the choice treatment.

Precision medicine – teamed up with the unstoppable data-crunching skills of machine learning – lays the groundwork for evolving strategies to tackle knee OA in overweight and obese individuals. The individual treatment decisions from precision medicine’s approach are reproducible, data driven, and extendable to other clinical settings. As the shot clock runs down, it’s undeniable – precision medicine can transform the landscape of knee OA treatment by offering individualized care.

Want to learn more?

See the Q&A on theMednet.org about the following question: How do you counsel patients on the benefits of diet and exercise in OA in a way that motivates them to comply?

Next Report: ADIRA

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