Biomarkers in early osteoarthritis (eOA) could serve as surrogate endpoints for clinical trials and allow early clinical intervention to slow progression of the disease. The aims of this review were to provide a comprehensive list of molecular biomarkers and biomarker panels to aid in the diagnosis of early knee osteoarthritis (eOA) that have been reported since August 2013.
MEDLINE and Embase databases were searched from August 2013 to May 2018 using the keywords “knee osteoarthritis”, “hip osteoarthritis”, “osteoarthritis” and “biomarker”. Studies were screened by abstract initially using the inclusion and exclusion criteria.
A total of 95 statistically significant, individual, molecular biomarkers were identified. Indian hedgehog protein, interleukin-8 and Chemokine (C-C motif) ligand 3 (CCL3) all had the ability to discern eOA patients from both healthy controls and individuals with advanced osteoarthritis. CCL3 had an area under the receiver operating characteristic curve (AUC) of 0.799 when diagnosing eOA. 11 biomarker panels were identified across 6 studies. One panel combined anti-cyclic citrullinated protein antibody with biomarkers of protein oxidation, nitration and glycation and had an AUC=0.98 when diagnosing eOA. Another panel achieved an AUC=0.872 when predicting the incidence of OA over 2.5 years in healthy controls. Biomarker panels did not perform as well at predicting 24-month case status in individuals already diagnosed with OA.
CCL3 was the most capable singular biomarker for diagnosing eOA. However, biomarker panels performed the best when diagnosing eOA. In order for further research to be as effective as possible a universal consensus must be reached regarding the definition and staging of eOA. The biomarkers and biomarker panels identified from this review have the ability to provide an objective method to aid clinicians and researchers in diagnosing osteoarthritis in its early stages.