Monitoring anti-TNF{alpha} treatment in RA: Responsiveness of magnetic resonance imaging and ultrasonography of the dominant wrist compared to conventional measures of disease activity and structural damage

Espen A Haavardsholm; Mikkel Ostergaard; Hilde Berner Hammer; Pernille Bøyesen; Annelies Boonen; Désirée van der Heijde; Tore K Kvien

doi:http://dx.doi.org/10.1136/ard.2008.091801

Monitoring anti-TNF{alpha} treatment in RA: Responsiveness of magnetic resonance imaging and ultrasonography of the dominant wrist compared to conventional measures of disease activity and structural damage

Espen A Haavardsholm, Mikkel Ostergaard, Hilde Berner Hammer, Pernille Bøyesen, Annelies Boonen, Désirée van der Heijde, Tore K Kvien

80 Citations (Scopus)

Abstract

OBJECTIVES: The objective of this study was to evaluate the responsiveness of magnetic resonance imaging (MRI) and ultrasonography (US) compared to conventional measures of disease activity and structural damage in RA patients during the first year of anti-TNFalpha treatment. METHODS: A cohort of RA patients (N=36, median age 53 years, disease duration 7.6 years and DAS28 5.7) was evaluated by core measures of disease activity, US (one wrist), MRI (one wrist) and conventional radiography (CR, both hands and wrists) at initiation of treatment with anti-TNFalpha agents and after 3, 6 and 12 months. Responsiveness was assessed by standardized response means (SRM). Accepted thresholds were applied to classify responsiveness as trivial, low, moderate or good. RESULTS: MRI synovitis (SRM between -0.79 and -0.92) and the MRI total inflammation score comprising synovitis, tenosynovitis and bone marrow edema (SRM between -1.05 and -1.24) were highly responsive. Moderate to high responsiveness was found for MRI tenosynovitis and bone marrow edema, all the composite indices (DAS28, SDAI and CDAI) and the 28-swollen joint count. US displayed low to moderate responsiveness. The MRI erosion score displayed low responsiveness, but was more responsive than CR measures at 3 and 6 months follow-up. MRI and CR measures of annual progression rates of damage performed similarly, and were highly responsive. CONCLUSIONS: The most responsive measure of inflammation when evaluating anti-TNFalpha medication was a composite measure comprising MRI synovitis, tenosynovitis and bone marrow edema, and this may be a promising outcome measure in clinical studies.

Original language	English
Journal	Annals of the Rheumatic Diseases
Volume	68
Pages (from-to)	572-79
ISSN	0003-4967
DOIs	https://doi.org/10.1136/ard.2008.091801
Publication status	Published - 2008

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Haavardsholm, E. A., Ostergaard, M., Hammer, H. B., Bøyesen, P., Boonen, A., van der Heijde, D., & Kvien, T. K. (2008). Monitoring anti-TNF{alpha} treatment in RA: Responsiveness of magnetic resonance imaging and ultrasonography of the dominant wrist compared to conventional measures of disease activity and structural damage. Annals of the Rheumatic Diseases, 68, 572-79. https://doi.org/10.1136/ard.2008.091801

Monitoring anti-TNF{alpha} treatment in RA: Responsiveness of magnetic resonance imaging and ultrasonography of the dominant wrist compared to conventional measures of disease activity and structural damage. / Haavardsholm, Espen A; Ostergaard, Mikkel; Hammer, Hilde Berner et al.

In: Annals of the Rheumatic Diseases, Vol. 68, 2008, p. 572-79.

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

Haavardsholm, EA, Ostergaard, M, Hammer, HB, Bøyesen, P, Boonen, A, van der Heijde, D & Kvien, TK 2008, 'Monitoring anti-TNF{alpha} treatment in RA: Responsiveness of magnetic resonance imaging and ultrasonography of the dominant wrist compared to conventional measures of disease activity and structural damage', Annals of the Rheumatic Diseases, vol. 68, pp. 572-79. https://doi.org/10.1136/ard.2008.091801

Haavardsholm EA, Ostergaard M, Hammer HB, Bøyesen P, Boonen A, van der Heijde D et al. Monitoring anti-TNF{alpha} treatment in RA: Responsiveness of magnetic resonance imaging and ultrasonography of the dominant wrist compared to conventional measures of disease activity and structural damage. Annals of the Rheumatic Diseases. 2008;68:572-79. doi: http://dx.doi.org/10.1136/ard.2008.091801

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title = "Monitoring anti-TNF{alpha} treatment in RA: Responsiveness of magnetic resonance imaging and ultrasonography of the dominant wrist compared to conventional measures of disease activity and structural damage",

abstract = "OBJECTIVES: The objective of this study was to evaluate the responsiveness of magnetic resonance imaging (MRI) and ultrasonography (US) compared to conventional measures of disease activity and structural damage in RA patients during the first year of anti-TNFalpha treatment. METHODS: A cohort of RA patients (N=36, median age 53 years, disease duration 7.6 years and DAS28 5.7) was evaluated by core measures of disease activity, US (one wrist), MRI (one wrist) and conventional radiography (CR, both hands and wrists) at initiation of treatment with anti-TNFalpha agents and after 3, 6 and 12 months. Responsiveness was assessed by standardized response means (SRM). Accepted thresholds were applied to classify responsiveness as trivial, low, moderate or good. RESULTS: MRI synovitis (SRM between -0.79 and -0.92) and the MRI total inflammation score comprising synovitis, tenosynovitis and bone marrow edema (SRM between -1.05 and -1.24) were highly responsive. Moderate to high responsiveness was found for MRI tenosynovitis and bone marrow edema, all the composite indices (DAS28, SDAI and CDAI) and the 28-swollen joint count. US displayed low to moderate responsiveness. The MRI erosion score displayed low responsiveness, but was more responsive than CR measures at 3 and 6 months follow-up. MRI and CR measures of annual progression rates of damage performed similarly, and were highly responsive. CONCLUSIONS: The most responsive measure of inflammation when evaluating anti-TNFalpha medication was a composite measure comprising MRI synovitis, tenosynovitis and bone marrow edema, and this may be a promising outcome measure in clinical studies.",

author = "Haavardsholm, {Espen A} and Mikkel Ostergaard and Hammer, {Hilde Berner} and Pernille B{\o}yesen and Annelies Boonen and {van der Heijde}, D{\'e}sir{\'e}e and Kvien, {Tore K}",

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doi = "http://dx.doi.org/10.1136/ard.2008.091801",

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T1 - Monitoring anti-TNF{alpha} treatment in RA: Responsiveness of magnetic resonance imaging and ultrasonography of the dominant wrist compared to conventional measures of disease activity and structural damage

AU - Haavardsholm, Espen A

AU - Ostergaard, Mikkel

AU - Hammer, Hilde Berner

AU - Bøyesen, Pernille

AU - Boonen, Annelies

AU - van der Heijde, Désirée

AU - Kvien, Tore K

PY - 2008

Y1 - 2008

N2 - OBJECTIVES: The objective of this study was to evaluate the responsiveness of magnetic resonance imaging (MRI) and ultrasonography (US) compared to conventional measures of disease activity and structural damage in RA patients during the first year of anti-TNFalpha treatment. METHODS: A cohort of RA patients (N=36, median age 53 years, disease duration 7.6 years and DAS28 5.7) was evaluated by core measures of disease activity, US (one wrist), MRI (one wrist) and conventional radiography (CR, both hands and wrists) at initiation of treatment with anti-TNFalpha agents and after 3, 6 and 12 months. Responsiveness was assessed by standardized response means (SRM). Accepted thresholds were applied to classify responsiveness as trivial, low, moderate or good. RESULTS: MRI synovitis (SRM between -0.79 and -0.92) and the MRI total inflammation score comprising synovitis, tenosynovitis and bone marrow edema (SRM between -1.05 and -1.24) were highly responsive. Moderate to high responsiveness was found for MRI tenosynovitis and bone marrow edema, all the composite indices (DAS28, SDAI and CDAI) and the 28-swollen joint count. US displayed low to moderate responsiveness. The MRI erosion score displayed low responsiveness, but was more responsive than CR measures at 3 and 6 months follow-up. MRI and CR measures of annual progression rates of damage performed similarly, and were highly responsive. CONCLUSIONS: The most responsive measure of inflammation when evaluating anti-TNFalpha medication was a composite measure comprising MRI synovitis, tenosynovitis and bone marrow edema, and this may be a promising outcome measure in clinical studies.

AB - OBJECTIVES: The objective of this study was to evaluate the responsiveness of magnetic resonance imaging (MRI) and ultrasonography (US) compared to conventional measures of disease activity and structural damage in RA patients during the first year of anti-TNFalpha treatment. METHODS: A cohort of RA patients (N=36, median age 53 years, disease duration 7.6 years and DAS28 5.7) was evaluated by core measures of disease activity, US (one wrist), MRI (one wrist) and conventional radiography (CR, both hands and wrists) at initiation of treatment with anti-TNFalpha agents and after 3, 6 and 12 months. Responsiveness was assessed by standardized response means (SRM). Accepted thresholds were applied to classify responsiveness as trivial, low, moderate or good. RESULTS: MRI synovitis (SRM between -0.79 and -0.92) and the MRI total inflammation score comprising synovitis, tenosynovitis and bone marrow edema (SRM between -1.05 and -1.24) were highly responsive. Moderate to high responsiveness was found for MRI tenosynovitis and bone marrow edema, all the composite indices (DAS28, SDAI and CDAI) and the 28-swollen joint count. US displayed low to moderate responsiveness. The MRI erosion score displayed low responsiveness, but was more responsive than CR measures at 3 and 6 months follow-up. MRI and CR measures of annual progression rates of damage performed similarly, and were highly responsive. CONCLUSIONS: The most responsive measure of inflammation when evaluating anti-TNFalpha medication was a composite measure comprising MRI synovitis, tenosynovitis and bone marrow edema, and this may be a promising outcome measure in clinical studies.

U2 - http://dx.doi.org/10.1136/ard.2008.091801

DO - http://dx.doi.org/10.1136/ard.2008.091801

M3 - Journal article

SN - 0003-4967

VL - 68

SP - 572

EP - 579

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

ER -