Abstract
Objective To determine thresholds for rheumatoid arthritis (RA) magnetic resonance imaging scores (RAMRIS) associated with a low risk of structural damage progression. Methods MRI of the dominant hand was performed and RAMRIS scores determined at weeks 0, 24, and 52. X-rays were performed and van der Heijde-Sharp scores (vdHS) determined. In a development cohort (n=297) the changes in MRI erosion score and vdHS score were determined over the 24-week to 52-week interval and progression was defined as change > 0.5. We identified 24-week thresholds for synovitis and osteitis that provided > 90% sensitivity for imaging progression over the 24 to 52-week interval. The performance of these cut-offs was tested in a validation cohort (n=217). Results In the development cohort, synovitis or osteitis scores ≤3 by 24 weeks were associated with a low probability of progression on MRI and x-ray. The coefficient for osteitis was stronger than that of synovitis in models predicting x-ray and MRI progression. Therefore, a total inflammation score was weighted on osteitis (x2). An inflammation score ≤ 9 was more frequently attained than DAS28 remission (64 vs. 38) and was associated with low probability of progression regardless of attainment of clinical remission. In the validation cohort, there was a low odds of MRI progression among those with low synovitis [OR 0.27 (0.086,0.82) p=0.02], osteitis [OR 0.20 (0.085, 0.49) p < 0.001] and inflammation scores [OR 0.12 (0.033, 0.41) p=0.001]. Conclusion Attainment of low MRI single-hand synovitis and osteitis is not uncommon and predicts a lack of structural progression in RA, independent of clinical remission.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Clinical and Experimental Rheumatology |
| Vol/bind | 35 |
| Udgave nummer | 4 |
| Sider (fra-til) | 607-613 |
| Antal sider | 7 |
| ISSN | 0392-856X |
| Status | Udgivet - 2017 |