Clinically Relevant Molecular Biomarkers for use in Human Knee Osteoarthritis: A Systematic Review

Research output: Contribution to journalArticlepeer-review


1. Objective
Biomarkers in osteoarthritis (OA) could serve as objective clinical indicators for various disease parameters, and act as surrogate endpoints in clinical trials for disease modifying drugs. The aim of this systematic review was to produce a comprehensive list of candidate molecular biomarkers for knee OA after the 2013 ESCEO review and discern whether any have been studied in sufficient detail for use in clinical settings.

2. Design
MEDLINE and Embase databases were searched between August 2013 and May 2018 using the keywords “knee osteoarthritis”, “osteoarthritis” and “biomarker”. Studies were screened by title, abstract and full text. Human studies on knee OA that were published in the English language were included. Excluded were studies on genetic/imaging/cellular markers, studies on participants with secondary OA, and publications that were review/abstract-only . Study quality and bias was assessed. Statistically significant data regarding the relationship between a biomarker and a disease parameter were extracted.

3. Results
80 studies were included in the final review and 89 statistically significant individual molecular biomarkers were identified.
C-telopeptide of type II collagen (CTXII) was shown to predict progression of knee OA in urine and serum in multiple studies. Synovial fluid vascular endothelial growth factor concentration was reported by two studies to be predictive of knee OA progression.

4. Conclusion
Despite the clear need for biomarkers of OA, the lack of coordination in current research has led to incompatible results. As such, there is yet to be a suitable biomarker to be used in a clinical setting.
Original languageEnglish
Pages (from-to)1947603520941239
Early online date17 Jul 2020
Publication statusE-pub ahead of print - 17 Jul 2020


  • biomarkers
  • molecular biomarkers
  • Osteoarthritis
  • knee


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