Erosive progression is minimal, but erosion healing rare, in patients with rheumatoid arthritis treated with adalimumab. A 1 year investigator-initiated follow-up study using high-resolution computed tomography as the primary outcome measure

U Møller Døhn; A Boonen; M L Hetland; M S Hansen; L S Knudsen; A Hansen; O R Madsen; M Hasselquist; J M Møller; M Østergaard

doi:10.1136/ard.2008.097048

Erosive progression is minimal, but erosion healing rare, in patients with rheumatoid arthritis treated with adalimumab. A 1 year investigator-initiated follow-up study using high-resolution computed tomography as the primary outcome measure

U Møller Døhn, A Boonen, M L Hetland, M S Hansen, L S Knudsen, A Hansen, O R Madsen, M Hasselquist, J M Møller, M Østergaard

74 Citations (Scopus)

Abstract

OBJECTIVE: With computed tomography (CT) and radiography, to investigate if repair of bone erosions, defined as regression of erosion scores, occurs during adalimumab treatment of patients with rheumatoid arthritis (RA). METHODS: Fifty-two patients with RA, naïve to biological agents, with at least two low-grade radiographic erosions in the wrist or metacarpophalangeal (MCP) joints in the same (index) hand, initiated adalimumab 40 mg subcutaneously every other week. Thirty-five patients completed the study (median age 61 years (interquartile range 46-68), disease duration 8 years (3-15)). CT of the index wrist and MCP joints 2-5 and radiographs of hands and forefeet were obtained at baseline, 6 and 12 months. Images were evaluated by investigators blinded to chronology and clinical data, and assessed according to Sharp/van der Heijde (radiographs) and OMERACT RA MRI scoring (CT) methods. RESULTS: Disease activity score, C-reactive protein, tender and swollen joints count and Health Assessment Questionnaire score had all decreased at 6 and 12 months (wilcoxon signed-ranks test p<0.001). No significant change in any imaging parameters of joint destruction was observed at 6 and 12 months. High intrareader agreements were reached (mean intraobserver intraclass coefficients: 0.96 (CT) and 0.97 (radiography)). The number of patients with change scores exceeding the smallest detectable change (SDC) was comparable on CT and radiography, as were the proportions of patients progressing/regressing. Decreased erosion scores at 12 months were registered in 1.6% and 1.8% of sites assessed on CT and radiography, respectively. CONCLUSION: Repair of erosions in adalimumab-treated patients with RA is rare, but erosive regression, exceeding the SDC, on CT and radiography occurred. The very limited overall erosive progression supports the view that joint destruction is minimal during adalimumab treatment of patients with RA.

Original language	English
Journal	Annals of the Rheumatic Diseases
Volume	68
Issue number	10
Pages (from-to)	1585-90
Number of pages	6
ISSN	0003-4967
DOIs	https://doi.org/10.1136/ard.2008.097048
Publication status	Published - 2009

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Møller Døhn, U., Boonen, A., Hetland, M. L., Hansen, M. S., Knudsen, L. S., Hansen, A., Madsen, O. R., Hasselquist, M., Møller, J. M., & Østergaard, M. (2009). Erosive progression is minimal, but erosion healing rare, in patients with rheumatoid arthritis treated with adalimumab. A 1 year investigator-initiated follow-up study using high-resolution computed tomography as the primary outcome measure. Annals of the Rheumatic Diseases, 68(10), 1585-90. https://doi.org/10.1136/ard.2008.097048

Erosive progression is minimal, but erosion healing rare, in patients with rheumatoid arthritis treated with adalimumab. A 1 year investigator-initiated follow-up study using high-resolution computed tomography as the primary outcome measure. / Møller Døhn, U; Boonen, A; Hetland, M L et al.

In: Annals of the Rheumatic Diseases, Vol. 68, No. 10, 2009, p. 1585-90.

Research output: Contribution to journal › Journal article › Research › peer-review

Møller Døhn, U, Boonen, A, Hetland, ML, Hansen, MS, Knudsen, LS, Hansen, A, Madsen, OR, Hasselquist, M, Møller, JM & Østergaard, M 2009, 'Erosive progression is minimal, but erosion healing rare, in patients with rheumatoid arthritis treated with adalimumab. A 1 year investigator-initiated follow-up study using high-resolution computed tomography as the primary outcome measure', Annals of the Rheumatic Diseases, vol. 68, no. 10, pp. 1585-90. https://doi.org/10.1136/ard.2008.097048

Møller Døhn U, Boonen A, Hetland ML, Hansen MS, Knudsen LS, Hansen A et al. Erosive progression is minimal, but erosion healing rare, in patients with rheumatoid arthritis treated with adalimumab. A 1 year investigator-initiated follow-up study using high-resolution computed tomography as the primary outcome measure. Annals of the Rheumatic Diseases. 2009;68(10):1585-90. doi: 10.1136/ard.2008.097048

Møller Døhn, U ; Boonen, A ; Hetland, M L et al. / Erosive progression is minimal, but erosion healing rare, in patients with rheumatoid arthritis treated with adalimumab. A 1 year investigator-initiated follow-up study using high-resolution computed tomography as the primary outcome measure. In: Annals of the Rheumatic Diseases. 2009 ; Vol. 68, No. 10. pp. 1585-90.

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title = "Erosive progression is minimal, but erosion healing rare, in patients with rheumatoid arthritis treated with adalimumab. A 1 year investigator-initiated follow-up study using high-resolution computed tomography as the primary outcome measure",

abstract = "OBJECTIVE: With computed tomography (CT) and radiography, to investigate if repair of bone erosions, defined as regression of erosion scores, occurs during adalimumab treatment of patients with rheumatoid arthritis (RA). METHODS: Fifty-two patients with RA, na{\"i}ve to biological agents, with at least two low-grade radiographic erosions in the wrist or metacarpophalangeal (MCP) joints in the same (index) hand, initiated adalimumab 40 mg subcutaneously every other week. Thirty-five patients completed the study (median age 61 years (interquartile range 46-68), disease duration 8 years (3-15)). CT of the index wrist and MCP joints 2-5 and radiographs of hands and forefeet were obtained at baseline, 6 and 12 months. Images were evaluated by investigators blinded to chronology and clinical data, and assessed according to Sharp/van der Heijde (radiographs) and OMERACT RA MRI scoring (CT) methods. RESULTS: Disease activity score, C-reactive protein, tender and swollen joints count and Health Assessment Questionnaire score had all decreased at 6 and 12 months (wilcoxon signed-ranks test p<0.001). No significant change in any imaging parameters of joint destruction was observed at 6 and 12 months. High intrareader agreements were reached (mean intraobserver intraclass coefficients: 0.96 (CT) and 0.97 (radiography)). The number of patients with change scores exceeding the smallest detectable change (SDC) was comparable on CT and radiography, as were the proportions of patients progressing/regressing. Decreased erosion scores at 12 months were registered in 1.6% and 1.8% of sites assessed on CT and radiography, respectively. CONCLUSION: Repair of erosions in adalimumab-treated patients with RA is rare, but erosive regression, exceeding the SDC, on CT and radiography occurred. The very limited overall erosive progression supports the view that joint destruction is minimal during adalimumab treatment of patients with RA.",

author = "{M{\o}ller D{\o}hn}, U and A Boonen and Hetland, {M L} and Hansen, {M S} and Knudsen, {L S} and A Hansen and Madsen, {O R} and M Hasselquist and M{\o}ller, {J M} and M {\O}stergaard",

note = "Keywords: Aged; Antibodies, Monoclonal; Antirheumatic Agents; Arthritis, Rheumatoid; Female; Follow-Up Studies; Humans; Male; Middle Aged; Observer Variation; Tomography, X-Ray Computed; Tumor Necrosis Factor-alpha",

year = "2009",

doi = "10.1136/ard.2008.097048",

language = "English",

volume = "68",

pages = "1585--90",

journal = "Annals of the Rheumatic Diseases",

issn = "0003-4967",

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TY - JOUR

T1 - Erosive progression is minimal, but erosion healing rare, in patients with rheumatoid arthritis treated with adalimumab. A 1 year investigator-initiated follow-up study using high-resolution computed tomography as the primary outcome measure

AU - Møller Døhn, U

AU - Boonen, A

AU - Hetland, M L

AU - Hansen, M S

AU - Knudsen, L S

AU - Hansen, A

AU - Madsen, O R

AU - Hasselquist, M

AU - Møller, J M

AU - Østergaard, M

N1 - Keywords: Aged; Antibodies, Monoclonal; Antirheumatic Agents; Arthritis, Rheumatoid; Female; Follow-Up Studies; Humans; Male; Middle Aged; Observer Variation; Tomography, X-Ray Computed; Tumor Necrosis Factor-alpha

PY - 2009

Y1 - 2009

N2 - OBJECTIVE: With computed tomography (CT) and radiography, to investigate if repair of bone erosions, defined as regression of erosion scores, occurs during adalimumab treatment of patients with rheumatoid arthritis (RA). METHODS: Fifty-two patients with RA, naïve to biological agents, with at least two low-grade radiographic erosions in the wrist or metacarpophalangeal (MCP) joints in the same (index) hand, initiated adalimumab 40 mg subcutaneously every other week. Thirty-five patients completed the study (median age 61 years (interquartile range 46-68), disease duration 8 years (3-15)). CT of the index wrist and MCP joints 2-5 and radiographs of hands and forefeet were obtained at baseline, 6 and 12 months. Images were evaluated by investigators blinded to chronology and clinical data, and assessed according to Sharp/van der Heijde (radiographs) and OMERACT RA MRI scoring (CT) methods. RESULTS: Disease activity score, C-reactive protein, tender and swollen joints count and Health Assessment Questionnaire score had all decreased at 6 and 12 months (wilcoxon signed-ranks test p<0.001). No significant change in any imaging parameters of joint destruction was observed at 6 and 12 months. High intrareader agreements were reached (mean intraobserver intraclass coefficients: 0.96 (CT) and 0.97 (radiography)). The number of patients with change scores exceeding the smallest detectable change (SDC) was comparable on CT and radiography, as were the proportions of patients progressing/regressing. Decreased erosion scores at 12 months were registered in 1.6% and 1.8% of sites assessed on CT and radiography, respectively. CONCLUSION: Repair of erosions in adalimumab-treated patients with RA is rare, but erosive regression, exceeding the SDC, on CT and radiography occurred. The very limited overall erosive progression supports the view that joint destruction is minimal during adalimumab treatment of patients with RA.

AB - OBJECTIVE: With computed tomography (CT) and radiography, to investigate if repair of bone erosions, defined as regression of erosion scores, occurs during adalimumab treatment of patients with rheumatoid arthritis (RA). METHODS: Fifty-two patients with RA, naïve to biological agents, with at least two low-grade radiographic erosions in the wrist or metacarpophalangeal (MCP) joints in the same (index) hand, initiated adalimumab 40 mg subcutaneously every other week. Thirty-five patients completed the study (median age 61 years (interquartile range 46-68), disease duration 8 years (3-15)). CT of the index wrist and MCP joints 2-5 and radiographs of hands and forefeet were obtained at baseline, 6 and 12 months. Images were evaluated by investigators blinded to chronology and clinical data, and assessed according to Sharp/van der Heijde (radiographs) and OMERACT RA MRI scoring (CT) methods. RESULTS: Disease activity score, C-reactive protein, tender and swollen joints count and Health Assessment Questionnaire score had all decreased at 6 and 12 months (wilcoxon signed-ranks test p<0.001). No significant change in any imaging parameters of joint destruction was observed at 6 and 12 months. High intrareader agreements were reached (mean intraobserver intraclass coefficients: 0.96 (CT) and 0.97 (radiography)). The number of patients with change scores exceeding the smallest detectable change (SDC) was comparable on CT and radiography, as were the proportions of patients progressing/regressing. Decreased erosion scores at 12 months were registered in 1.6% and 1.8% of sites assessed on CT and radiography, respectively. CONCLUSION: Repair of erosions in adalimumab-treated patients with RA is rare, but erosive regression, exceeding the SDC, on CT and radiography occurred. The very limited overall erosive progression supports the view that joint destruction is minimal during adalimumab treatment of patients with RA.

U2 - 10.1136/ard.2008.097048

DO - 10.1136/ard.2008.097048

M3 - Journal article

C2 - 19019887

SN - 0003-4967

VL - 68

SP - 1585

EP - 1590

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

IS - 10

ER -