Very early MRI responses to therapy as a predictor of later radiographic progression in early rheumatoid arthritis
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Very early MRI responses to therapy as a predictor of later radiographic progression in early rheumatoid arthritis. / Conaghan, Philip G.; Østergaard, Mikkel; Troum, Orrin; Bowes, Michael A.; Guillard, Gwenael; Wilkinson, Bethanie; Xie, Zhiyong; Andrews, John; Stein, Amy; Chapman, Douglass; Koenig, Andrew.
In: Arthritis Research and Therapy, Vol. 21, 214, 2019.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - Very early MRI responses to therapy as a predictor of later radiographic progression in early rheumatoid arthritis
AU - Conaghan, Philip G.
AU - Østergaard, Mikkel
AU - Troum, Orrin
AU - Bowes, Michael A.
AU - Guillard, Gwenael
AU - Wilkinson, Bethanie
AU - Xie, Zhiyong
AU - Andrews, John
AU - Stein, Amy
AU - Chapman, Douglass
AU - Koenig, Andrew
PY - 2019
Y1 - 2019
N2 - Background: The objective of this study was to evaluate early changes in magnetic resonance imaging (MRI) and clinical disease activity measures as predictors of later structural progression in early rheumatoid arthritis (RA). Methods: This was a post hoc analysis of data pooled across treatments from a three-arm (tofacitinib monotherapy, tofacitinib with methotrexate [MTX], or MTX monotherapy) trial of MTX-naïve patients with early, active RA. Synovitis, osteitis and erosions were assessed with the Outcome Measures in Rheumatology (OMERACT) RA MRI scoring system (RAMRIS) and RAMRIQ (automated quantitative RA MRI assessment system; automated RAMRIS) at months 0, 1, 3, 6 and 12. Radiographs were assessed at months 0, 6 and 12, and clinical endpoints were assessed at all timepoints. Univariate and multivariate analyses explored the predictive value of early changes in RAMRIS/RAMRIQ parameters and disease activity measures, with respect to subsequent radiographic progression. Results: Data from 109 patients with a mean RA duration of 0.7 years were included. In univariate analyses, changes in RAMRIS erosions at months 1 and 3 significantly predicted radiographic progression at month 12 (both p < 0.01); changes in RAMRIQ synovitis and osteitis at months 1 and 3 were significant predictors of RAMRIS erosions and radiographic progression at month 12 (all p < 0.01). In subsequent multivariate analyses, RAMRIS erosion change at month 1 (p < 0.05) and RAMRIQ osteitis changes at months 1 and 3 (both p < 0.01) were significant independent predictors of radiographic progression at month 12. Univariate analyses demonstrated that changes in Clinical Disease Activity Index (CDAI) and Disease Activity Score in 28 joints, erythrocyte sedimentation rate (DAS28-4[ESR]) at months 1 and 3 were not predictive of month 12 radiographic progression. Conclusions: MRI changes seen as early as 1 month after RA treatment initiation have the potential to better predict long-term radiographic progression than changes in disease activity measures.
AB - Background: The objective of this study was to evaluate early changes in magnetic resonance imaging (MRI) and clinical disease activity measures as predictors of later structural progression in early rheumatoid arthritis (RA). Methods: This was a post hoc analysis of data pooled across treatments from a three-arm (tofacitinib monotherapy, tofacitinib with methotrexate [MTX], or MTX monotherapy) trial of MTX-naïve patients with early, active RA. Synovitis, osteitis and erosions were assessed with the Outcome Measures in Rheumatology (OMERACT) RA MRI scoring system (RAMRIS) and RAMRIQ (automated quantitative RA MRI assessment system; automated RAMRIS) at months 0, 1, 3, 6 and 12. Radiographs were assessed at months 0, 6 and 12, and clinical endpoints were assessed at all timepoints. Univariate and multivariate analyses explored the predictive value of early changes in RAMRIS/RAMRIQ parameters and disease activity measures, with respect to subsequent radiographic progression. Results: Data from 109 patients with a mean RA duration of 0.7 years were included. In univariate analyses, changes in RAMRIS erosions at months 1 and 3 significantly predicted radiographic progression at month 12 (both p < 0.01); changes in RAMRIQ synovitis and osteitis at months 1 and 3 were significant predictors of RAMRIS erosions and radiographic progression at month 12 (all p < 0.01). In subsequent multivariate analyses, RAMRIS erosion change at month 1 (p < 0.05) and RAMRIQ osteitis changes at months 1 and 3 (both p < 0.01) were significant independent predictors of radiographic progression at month 12. Univariate analyses demonstrated that changes in Clinical Disease Activity Index (CDAI) and Disease Activity Score in 28 joints, erythrocyte sedimentation rate (DAS28-4[ESR]) at months 1 and 3 were not predictive of month 12 radiographic progression. Conclusions: MRI changes seen as early as 1 month after RA treatment initiation have the potential to better predict long-term radiographic progression than changes in disease activity measures.
KW - Bone erosion
KW - Disease activity
KW - Joint space narrowing
KW - Osteitis
KW - Predictive ability
KW - Radiographic progression
KW - RAMRIQ
KW - RAMRIS
KW - Rheumatoid arthritis
KW - Synovitis
U2 - 10.1186/s13075-019-2000-1
DO - 10.1186/s13075-019-2000-1
M3 - Journal article
C2 - 31639034
AN - SCOPUS:85073753006
VL - 21
JO - Arthritis Research & Therapy
JF - Arthritis Research & Therapy
SN - 1478-6354
M1 - 214
ER -
ID: 232071323