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Research project


Status: Ongoing (January 2020-2023)

The FOCUM human disease model for development of osteoarthritis.

What we do

About our project

The prevalence of osteoarthritis sharply increases in women compared to men after the age of 50, which suggests a role of menopause in the development of osteoarthritis. Studying the influence of menopause is hampered by the slow hormonal change during menopausal transition. Identifying the (female specific) pathways that lead to osteoarthritis is however crucial to develop new prevention strategies and therapies for osteoarthritis. Therefore, we propose a novel human model for sudden menopause to investigate the influence of menopause on development of osteoarthritis: FOCUM (Females discontinuing Oral Contraceptives Use at Menopausal age).

We hypothesize that the FOCUM model will allow us to study in detail what happens immediately after a rapid change in hormones and it will enable us to identify (female specific) pathways for osteoarthritis.

An observational study will be conducted with a follow-up of two years. Women (n=50), 50 to 60 years of age, who are using a combined oral contraceptive, started oral contraceptive use before their 45th and aim to stop oral contraceptive use at short term will be included. Measurements (questionnaires, blood collection, MRI of the knees, x-rays of the hands) will be done just before stopping oral contraceptive use, at six weeks, six months, one and two years after stopping oral contraceptive use. Changes in different hormones and proteins between each time point will be estimated and related to osteoarthritis outcomes.

Our research focus

Primary outcome
The primary outcome is the progression of MRI features for knee osteoarthritis scored with the MOAKS.

Secondary outcome
Secondary outcomes are the development of knee or hand osteoarthritis according to the clinical ACR criteria, the development of knee osteoarthritis according to the MRI-definition and progression of X-ray features for hand osteoarthritis scored with the OARSI atlas.

Funds & Grants

The Dutch Arthritis Society (ReumaNederland) (18-2-204)


Department of Orthopedics
Department of Rheumatology
Department of Internal Medicine
Department of Radiology
Department of Epidemiology

Our team

Dr. D. Schiphof, d.schiphof@erasmusmc.nl
Dr. E.H.G. Oei, e.oei@erasmusmc.nl
Dr. Ir. J.H. Waarsing, e.waarsing@erasmusmc.nl
Dr. R.J. de Vos, r.devos@erasmusmc.nl
Dr. J.B.J. van Meurs, j.vanmeurs@erasmusmc.nl
Dr. E. Lubberts, e.lubberts@erasmusmc.nl
Dr. M.C. Zillikens, m.c.zillikens@erasmusmc.nl
Dr. B.C.J. van der Eerden, b.vandereerden@erasmusmc.nl
Dr. M. Kavousi, m.kavousi@erasmusmc.nl
Dr. B.W.V. Schouten, b.schouten@erasmusmc.nl
Drs. M.I.B. de Rooij-Duran, derooijduran@apotheekpendrecht.nl
Prof. Dr. P.J.E. Bindels, p.bindels@erasmusmc.nl
Prof. S.M.A. Bierma-Zeinstra, s.bierma-zeinstra@erasmusmc.nl

Contact address for the project: e.molendijk.1@erasmusmc.nl.