Identification of phenotypes with different clinical outcomes in knee osteoarthritis: Data from the osteoarthritis initiative

Abstract Objective To identify subgroups or phenotypes of knee osteoarthritis (OA) patients based on similarities of clinically relevant patient characteristics, and to compare clinical outcomes of these phenotypes. Methods Data from 842 knee OA patients of the Osteoarthritis Initiative were used. A cluster analysis method was performed, in which clusters were formed based on similarities in 4 clinically relevant, easily available variables: severity of radiographic OA, lower extremity muscle strength, body mass index, and depression. Univariable and multivariable regression analyses were used to compare phenotypes on clinical outcomes (pain and activity limitations), taking into account possible confounders. Results Five phenotypes of knee OA patients were identified: “minimal joint disease phenotype,” “strong muscle phenotype,” “nonobese and weak muscle phenotype,” “obese and weak muscle phenotype,” and “depressive phenotype.” The “depressive phenotype” and “obese and weak muscle phenotype” showed higher pain levels and more severe activity limitations than the other 3 phenotypes. Conclusion Five phenotypes based on clinically relevant patient characteristics can be identified in the heterogeneous population of knee OA patients. These phenotypes showed different clinical outcomes. Interventions may need to be tailored to these clinical phenotypes.