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Objectives <p>Knee subchondral bone marrow lesions (BMLs) are one of the hallmark features of structural osteoarthritis (OA) and are potential targets for statins’ disease-modifying effect. We aimed to determine the association between statin use and longitudinal changes in magnetic resonance imaging (MRI)-based BML volume in participants without radiographic knee OA&#xa0;at baseline.</p> Methods <p>Using the Osteoarthritis Initiative (OAI) cohort, we classified participants’ knees into two categories: statin users (those who consistently used statins from baseline to the fourth year of the cohort) and non-users. We employed a 1:1 ratio propensity score (PS) matching method, adjusting for factors including age, sex, race, BMI, smoking, alcohol use, physical activity, abdominal obesity, and diabetes mellitus. We measured quantitative BML volume using a validated deep learning (DL) algorithm, applied to baseline, year-2, and year-4 intermediate-weighted fat-saturated knee MRIs. The outcome was determined by the differences in the BML volume change between statin users and non-users over the 4-year period.</p> Results <p>After adjusting for potential confounders, 1502 knees were included (751 statin users&#xa0;and&#xa0;751 non-users; mean age&#xa0;63.5 ± 8.7&#xa0;years, 44.5%&#xa0;female). A&#xa0;Multilevel linear mixed-effects regression model showed that statin use is associated with a smaller increase in BML volume over 4&#xa0;years (time–treatment interaction effect estimates, 95% confidence interval (CI) − 14.88 mm<sup>3</sup>/year, − 23.04 to − 6.72, <i>P</i> &lt; 0.001).</p> Conclusion <p>In participants without baseline knee OA, continuous statin use is associated with&#xa0;a reduced longitudinal worsening of BML&#xa0;volume in&#xa0;the tibiofemoral joint, a known structural damage&#xa0;marker linked to downstream OA incidence.</p>

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Statin use and longitudinal bone marrow lesion burden: analysis of knees without osteoarthritis from the Osteoarthritis Initiative study

  • 期刊论文

  • 发表日期：

    2025年1月31日

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  • Kamyar Moradi,
  • Bahram Mohajer,
  • Ali Guermazi,
  • Roham Hadidchi,
  • Soheil Mohammadi,
  • Xu Cao,
  • Mei Wan,
  • Frank W. Roemer,
  • Shadpour Demehri

摘要

Objectives

Knee subchondral bone marrow lesions (BMLs) are one of the hallmark features of structural osteoarthritis (OA) and are potential targets for statins’ disease-modifying effect. We aimed to determine the association between statin use and longitudinal changes in magnetic resonance imaging (MRI)-based BML volume in participants without radiographic knee OA at baseline.

Methods

Using the Osteoarthritis Initiative (OAI) cohort, we classified participants’ knees into two categories: statin users (those who consistently used statins from baseline to the fourth year of the cohort) and non-users. We employed a 1:1 ratio propensity score (PS) matching method, adjusting for factors including age, sex, race, BMI, smoking, alcohol use, physical activity, abdominal obesity, and diabetes mellitus. We measured quantitative BML volume using a validated deep learning (DL) algorithm, applied to baseline, year-2, and year-4 intermediate-weighted fat-saturated knee MRIs. The outcome was determined by the differences in the BML volume change between statin users and non-users over the 4-year period.

Results

After adjusting for potential confounders, 1502 knees were included (751 statin users and 751 non-users; mean age 63.5 ± 8.7 years, 44.5% female). A Multilevel linear mixed-effects regression model showed that statin use is associated with a smaller increase in BML volume over 4 years (time–treatment interaction effect estimates, 95% confidence interval (CI) − 14.88 mm3/year, − 23.04 to − 6.72, P < 0.001).

Conclusion

In participants without baseline knee OA, continuous statin use is associated with a reduced longitudinal worsening of BML volume in the tibiofemoral joint, a known structural damage marker linked to downstream OA incidence.