Strategic application of imaging in DMOAD clinical trials: focus on eligibility, drug delivery, and semiquantitative assessment of structural progression

This recent article by Dr. Guermazi describes in detail strategies to successfully run the imaging arm of any given DMOAD trial. Radiography has many short comings and should only be applied for screening purposes. Medicine is increasingly tailored to the needs of any given patient and trial design should reflect this. In this perspective paper, the BICL OA experts describe their profound experience with MRI-based tools and analytic methods that can be applied to DMOAD clinical trials with a particular emphasis on knee OA. Drug delivery is one important aspect of a successful trial and correct intra-articular application needs proper documentation to avoid adverse events. Today MRI should be the modality of choice for eligibility screening and outcome assessment. Optimal MRI pulse sequences must be chosen to visualize specific features of OA.