University of Oulu

van Helvoort EM, Welsing PMJ, Jansen MP, et al. Neuropathic pain in the IMI-APPROACH knee osteoarthritis cohort: prevalence and phenotyping. RMD Open 2021;7:e002025. doi: 10.1136/rmdopen-2021-002025

Neuropathic pain in the IMI-APPROACH knee osteoarthritis cohort : prevalence and phenotyping

Saved in:
Author: van Helvoort, Eefje Martine1; Welsing, Paco M J1; Jansen, Mylène P1;
Organizations: 1Rheumatology & Clinical Immunology, UMC Utrecht, Utrecht University, Utrecht, The Netherlands
2Orthopedics, UMC Utrecht, Utrecht University, Utrecht, The Netherlands
3Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
4Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
5Servicio de Reumatologia, INIBIC-Hospital Universitario A Coruña, A Coruña, Spain
6Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
7Rheumatology, Sorbonne Université, Paris, France
8INSERM, Paris, France
9Nordic Bioscience, Herlev, Denmark
10BioBone BV, Amsterdam, The Netherlands
11Institut de Recherches Internationales Servier, Suresnes, France
12GlaxoSmithKline USA, Philadelphia, Pennsylvania, USA
13Musculoskeletal Research Group, Newcastle University, Newcastle upon Tyne, UK
14Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
15Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
16Orthopedics, UMC Utrecht, University Utrecht, Utrecht, The Netherlands
17Center for Translational Immunology, UMC Utrecht, Utrecht University, Utrecht, The Netherlands
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
Persistent link:
Language: English
Published: BMJ, 2021
Publish Date: 2022-02-21


Objectives: Osteoarthritis (OA) patients with a neuropathic pain (NP) component may represent a specific phenotype. This study compares joint damage, pain and functional disability between knee OA patients with a likely NP component, and those without a likely NP component.

Methods: Baseline data from the Innovative Medicines Initiative Applied Public-Private Research enabling OsteoArthritis Clinical Headway knee OA cohort study were used. Patients with a painDETECT score ≥19 (with likely NP component, n=24) were matched on a 1:2 ratio to patients with a painDETECT score ≤12 (without likely NP component), and similar knee and general pain (Knee Injury and Osteoarthritis Outcome Score pain and Short Form 36 pain). Pain, physical function and radiographic joint damage of multiple joints were determined and compared between OA patients with and without a likely NP component.

Results: OA patients with painDETECT scores ≥19 had statistically significant less radiographic joint damage (p≤0.04 for Knee Images Digital Analysis parameters and Kellgren and Lawrence grade), but an impaired physical function (p<0.003 for all tests) compared with patients with a painDETECT score ≤12. In addition, more severe pain was found in joints other than the index knee (p≤0.001 for hips and hands), while joint damage throughout the body was not different.

Conclusions: OA patients with a likely NP component, as determined with the painDETECT questionnaire, may represent a specific OA phenotype, where local and overall joint damage is not the main cause of pain and disability. Patients with this NP component will likely not benefit from general pain medication and/or disease-modifying OA drug (DMOAD) therapy. Reserved inclusion of these patients in DMOAD trials is advised in the quest for successful OA treatments. Trial registration number. The study is registered under nr: NCT03883568.

see all

Series: RMD open
ISSN: 2056-5933
ISSN-E: 2056-5933
ISSN-L: 2056-5933
Volume: 7
Issue: 3
Article number: e002025
DOI: 10.1136/rmdopen-2021-002025
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: This work was supported by the Innovative Medicines Initiative Joint Undertaking under Grant Agreement no 115770, resources of which are composed of financial contribution from the European Union’s Seventh Framework Programme (FP7/2007-2013) and EFPIA companies’ in kind contribution. See and
Copyright information: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: