The elderly were under-represented in osteoarthritis clinical trials

George Liberopoulos, Nikolaos A. Trikalinos, John P.A. Ioannidis

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Objectives: Osteoarthritis is the most common disease affecting joints in the elderly. We aimed to evaluate if elderly patients are properly represented in clinical trials of diverse osteoarthritis interventions. Study Design and Setting: Clinical trials of osteoarthritis interventions were retrieved from Cochrane Library systematic reviews (2006, issue 2). We examined the age distribution of the trial participants and eligibility criteria. Results: We analyzed data from 219 eligible trials from 18 systematic reviews. The average mean age of the participants was 63 years. Only 13 trials (6.4%) had a mean age between 71 and 80 years and only one trial had a mean age exceeding 80 years. Among trials where the age range of participants was available or could be approximately inferred, we estimated that 66 (38%) trials had not included any patients over 80 years old. Only 23 trials specifically excluded patients over 70 based on reported eligibility criteria, but 168 trials excluded patients with various comorbidities and 142 trials excluded patients receiving other specific treatments. Conclusions: Elderly patients are considerably under-represented in clinical trials of osteoarthritis. This causes an important deficit in the utility, relevance, and generalizability of trial results for this very common condition.

Original languageEnglish
Pages (from-to)1218-1223
Number of pages6
JournalJournal of Clinical Epidemiology
Issue number11
StatePublished - Nov 2009


  • Elderly
  • Enrollment
  • Osteoarthritis
  • Participation
  • Randomized clinical trial
  • Representation


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