No overall damage progression despite persistent inflammation in adalimumab-treated psoriatic arthritis patients: results from an investigator-initiated 48-week comparative magnetic resonance imaging, computed tomography and radiography trial

René Panduro Poggenborg; Charlotte Wiell; Pernille Bøyesen; Annelies Boonen; Paul Bird; Susanne Juhl Pedersen; Inge Juul Sørensen; Ole Rintek Madsen; Ole Slot; Jakob M Møller; Maria Hasselquist; Olga Kubassova; Mikkel Østergaard

doi:10.1093/rheumatology/ket426

No overall damage progression despite persistent inflammation in adalimumab-treated psoriatic arthritis patients: results from an investigator-initiated 48-week comparative magnetic resonance imaging, computed tomography and radiography trial

René Panduro Poggenborg, Charlotte Wiell, Pernille Bøyesen, Annelies Boonen, Paul Bird, Susanne Juhl Pedersen, Inge Juul Sørensen, Ole Rintek Madsen, Ole Slot, Jakob M Møller, Maria Hasselquist, Olga Kubassova, Mikkel Østergaard

Department of Clinical Medicine

28 Citations (Scopus)

Abstract

Objective. In a comparative conventional MRI, dynamic contrast-enhanced (DCE)-MRI, CT and radiography study, the authors aimed to monitor whether inflammation is reduced or even eliminated and damage halted in PsA patients receiving anti-TNF therapy.Methods. A 48-week prospective open-label investigator-initiated trial of 41 biologic-naive patients treated with 40 mg adalimumab every other week. Hand CT, MRI (according to the PsA MRI scoring system method) and radiography (Sharp-van der Heijde method) were obtained at weeks 0, 6 (only MRI), 24 and 48. Clinical response was assessed by the PsA Response Criteria (PsARC).Results. In the 23 PsARC responders at week 48, significant decreases from baseline in MRI synovitis (mean -2.0, P < 0.05), bone marrow oedema (BMO) (-1.3, P < 0.05), flexor tenosynovitis (-2.1, P < 0.05) and total inflammation (-6.0, P < 0.005) were observed. However, MRI signs of inflammation remained present (week 48 total inflammation score median = 9). Several DCE-MRI parameters also decreased (P < 0.05) and were correlated (ρ = 0.62) with conventional MRI total inflammation score. No statistically significant changes in bone erosion or proliferation scores were observed. With CT as the standard reference for detecting bone erosions/proliferations, sensitivity, specificity and accuracy were 100%/40%, 83%/93% and 84%/86%, respectively, for MRI, whereas corresponding values for radiography were 17%/26%, 98%/96%, and 93%/87%, respectively. Erosive progression as assessed by CT was found in 6 of 480 joints and baseline BMO was predictive (relative risk 10, 95% CI 2.1, 49).Conclusion. MRI signs of inflammation decrease, but do not disappear, during anti-TNF-α therapy. No overall changes in bone erosions or proliferations were observed. On joint-level baseline MRI, BMO was related to subsequent erosive progression detected by CT.Trial registration: ClinicalTrials.gov, http://clinicaltrials.gov/, NCT01465438.

Original language	English
Journal	Rheumatology (Oxford, England)
Volume	53
Issue number	4
Pages (from-to)	746-756
Number of pages	11
ISSN	1462-0324
DOIs	https://doi.org/10.1093/rheumatology/ket426
Publication status	Published - Apr 2014

Keywords

Adult
Anti-Inflammatory Agents
Antibodies, Monoclonal, Humanized
Arthritis, Psoriatic
Disease-Free Survival
Female
Hand Joints
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Prospective Studies
Synovitis
Tomography, X-Ray Computed
Treatment Outcome

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Poggenborg, R. P., Wiell, C., Bøyesen, P., Boonen, A., Bird, P., Pedersen, S. J., Sørensen, I. J., Madsen, O. R., Slot, O., Møller, J. M., Hasselquist, M., Kubassova, O., & Østergaard, M. (2014). No overall damage progression despite persistent inflammation in adalimumab-treated psoriatic arthritis patients: results from an investigator-initiated 48-week comparative magnetic resonance imaging, computed tomography and radiography trial. Rheumatology (Oxford, England), 53(4), 746-756. https://doi.org/10.1093/rheumatology/ket426

No overall damage progression despite persistent inflammation in adalimumab-treated psoriatic arthritis patients: results from an investigator-initiated 48-week comparative magnetic resonance imaging, computed tomography and radiography trial. / Poggenborg, René Panduro; Wiell, Charlotte; Bøyesen, Pernille et al.
In: Rheumatology (Oxford, England), Vol. 53, No. 4, 04.2014, p. 746-756.

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

Poggenborg, RP, Wiell, C, Bøyesen, P, Boonen, A, Bird, P, Pedersen, SJ, Sørensen, IJ, Madsen, OR, Slot, O, Møller, JM, Hasselquist, M, Kubassova, O & Østergaard, M 2014, 'No overall damage progression despite persistent inflammation in adalimumab-treated psoriatic arthritis patients: results from an investigator-initiated 48-week comparative magnetic resonance imaging, computed tomography and radiography trial', Rheumatology (Oxford, England), vol. 53, no. 4, pp. 746-756. https://doi.org/10.1093/rheumatology/ket426

Poggenborg RP, Wiell C, Bøyesen P, Boonen A, Bird P, Pedersen SJ et al. No overall damage progression despite persistent inflammation in adalimumab-treated psoriatic arthritis patients: results from an investigator-initiated 48-week comparative magnetic resonance imaging, computed tomography and radiography trial. Rheumatology (Oxford, England). 2014 Apr;53(4):746-756. doi: 10.1093/rheumatology/ket426

Poggenborg, René Panduro ; Wiell, Charlotte ; Bøyesen, Pernille et al. / No overall damage progression despite persistent inflammation in adalimumab-treated psoriatic arthritis patients : results from an investigator-initiated 48-week comparative magnetic resonance imaging, computed tomography and radiography trial. In: Rheumatology (Oxford, England). 2014 ; Vol. 53, No. 4. pp. 746-756.

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title = "No overall damage progression despite persistent inflammation in adalimumab-treated psoriatic arthritis patients: results from an investigator-initiated 48-week comparative magnetic resonance imaging, computed tomography and radiography trial",

abstract = "Objective. In a comparative conventional MRI, dynamic contrast-enhanced (DCE)-MRI, CT and radiography study, the authors aimed to monitor whether inflammation is reduced or even eliminated and damage halted in PsA patients receiving anti-TNF therapy.Methods. A 48-week prospective open-label investigator-initiated trial of 41 biologic-naive patients treated with 40 mg adalimumab every other week. Hand CT, MRI (according to the PsA MRI scoring system method) and radiography (Sharp-van der Heijde method) were obtained at weeks 0, 6 (only MRI), 24 and 48. Clinical response was assessed by the PsA Response Criteria (PsARC).Results. In the 23 PsARC responders at week 48, significant decreases from baseline in MRI synovitis (mean -2.0, P < 0.05), bone marrow oedema (BMO) (-1.3, P < 0.05), flexor tenosynovitis (-2.1, P < 0.05) and total inflammation (-6.0, P < 0.005) were observed. However, MRI signs of inflammation remained present (week 48 total inflammation score median = 9). Several DCE-MRI parameters also decreased (P < 0.05) and were correlated (ρ = 0.62) with conventional MRI total inflammation score. No statistically significant changes in bone erosion or proliferation scores were observed. With CT as the standard reference for detecting bone erosions/proliferations, sensitivity, specificity and accuracy were 100%/40%, 83%/93% and 84%/86%, respectively, for MRI, whereas corresponding values for radiography were 17%/26%, 98%/96%, and 93%/87%, respectively. Erosive progression as assessed by CT was found in 6 of 480 joints and baseline BMO was predictive (relative risk 10, 95% CI 2.1, 49).Conclusion. MRI signs of inflammation decrease, but do not disappear, during anti-TNF-α therapy. No overall changes in bone erosions or proliferations were observed. On joint-level baseline MRI, BMO was related to subsequent erosive progression detected by CT.Trial registration: ClinicalTrials.gov, http://clinicaltrials.gov/, NCT01465438.",

keywords = "Adult, Anti-Inflammatory Agents, Antibodies, Monoclonal, Humanized, Arthritis, Psoriatic, Disease-Free Survival, Female, Hand Joints, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Prospective Studies, Synovitis, Tomography, X-Ray Computed, Treatment Outcome",

author = "Poggenborg, {Ren{\'e} Panduro} and Charlotte Wiell and Pernille B{\o}yesen and Annelies Boonen and Paul Bird and Pedersen, {Susanne Juhl} and S{\o}rensen, {Inge Juul} and Madsen, {Ole Rintek} and Ole Slot and M{\o}ller, {Jakob M} and Maria Hasselquist and Olga Kubassova and Mikkel {\O}stergaard",

year = "2014",

month = apr,

doi = "10.1093/rheumatology/ket426",

language = "English",

volume = "53",

pages = "746--756",

journal = "Rheumatology (Oxford, England)",

issn = "1462-0324",

publisher = "Oxford University Press",

number = "4",

}

TY - JOUR

T1 - No overall damage progression despite persistent inflammation in adalimumab-treated psoriatic arthritis patients

T2 - results from an investigator-initiated 48-week comparative magnetic resonance imaging, computed tomography and radiography trial

AU - Poggenborg, René Panduro

AU - Wiell, Charlotte

AU - Bøyesen, Pernille

AU - Boonen, Annelies

AU - Bird, Paul

AU - Pedersen, Susanne Juhl

AU - Sørensen, Inge Juul

AU - Madsen, Ole Rintek

AU - Slot, Ole

AU - Møller, Jakob M

AU - Hasselquist, Maria

AU - Kubassova, Olga

AU - Østergaard, Mikkel

PY - 2014/4

Y1 - 2014/4

N2 - Objective. In a comparative conventional MRI, dynamic contrast-enhanced (DCE)-MRI, CT and radiography study, the authors aimed to monitor whether inflammation is reduced or even eliminated and damage halted in PsA patients receiving anti-TNF therapy.Methods. A 48-week prospective open-label investigator-initiated trial of 41 biologic-naive patients treated with 40 mg adalimumab every other week. Hand CT, MRI (according to the PsA MRI scoring system method) and radiography (Sharp-van der Heijde method) were obtained at weeks 0, 6 (only MRI), 24 and 48. Clinical response was assessed by the PsA Response Criteria (PsARC).Results. In the 23 PsARC responders at week 48, significant decreases from baseline in MRI synovitis (mean -2.0, P < 0.05), bone marrow oedema (BMO) (-1.3, P < 0.05), flexor tenosynovitis (-2.1, P < 0.05) and total inflammation (-6.0, P < 0.005) were observed. However, MRI signs of inflammation remained present (week 48 total inflammation score median = 9). Several DCE-MRI parameters also decreased (P < 0.05) and were correlated (ρ = 0.62) with conventional MRI total inflammation score. No statistically significant changes in bone erosion or proliferation scores were observed. With CT as the standard reference for detecting bone erosions/proliferations, sensitivity, specificity and accuracy were 100%/40%, 83%/93% and 84%/86%, respectively, for MRI, whereas corresponding values for radiography were 17%/26%, 98%/96%, and 93%/87%, respectively. Erosive progression as assessed by CT was found in 6 of 480 joints and baseline BMO was predictive (relative risk 10, 95% CI 2.1, 49).Conclusion. MRI signs of inflammation decrease, but do not disappear, during anti-TNF-α therapy. No overall changes in bone erosions or proliferations were observed. On joint-level baseline MRI, BMO was related to subsequent erosive progression detected by CT.Trial registration: ClinicalTrials.gov, http://clinicaltrials.gov/, NCT01465438.

AB - Objective. In a comparative conventional MRI, dynamic contrast-enhanced (DCE)-MRI, CT and radiography study, the authors aimed to monitor whether inflammation is reduced or even eliminated and damage halted in PsA patients receiving anti-TNF therapy.Methods. A 48-week prospective open-label investigator-initiated trial of 41 biologic-naive patients treated with 40 mg adalimumab every other week. Hand CT, MRI (according to the PsA MRI scoring system method) and radiography (Sharp-van der Heijde method) were obtained at weeks 0, 6 (only MRI), 24 and 48. Clinical response was assessed by the PsA Response Criteria (PsARC).Results. In the 23 PsARC responders at week 48, significant decreases from baseline in MRI synovitis (mean -2.0, P < 0.05), bone marrow oedema (BMO) (-1.3, P < 0.05), flexor tenosynovitis (-2.1, P < 0.05) and total inflammation (-6.0, P < 0.005) were observed. However, MRI signs of inflammation remained present (week 48 total inflammation score median = 9). Several DCE-MRI parameters also decreased (P < 0.05) and were correlated (ρ = 0.62) with conventional MRI total inflammation score. No statistically significant changes in bone erosion or proliferation scores were observed. With CT as the standard reference for detecting bone erosions/proliferations, sensitivity, specificity and accuracy were 100%/40%, 83%/93% and 84%/86%, respectively, for MRI, whereas corresponding values for radiography were 17%/26%, 98%/96%, and 93%/87%, respectively. Erosive progression as assessed by CT was found in 6 of 480 joints and baseline BMO was predictive (relative risk 10, 95% CI 2.1, 49).Conclusion. MRI signs of inflammation decrease, but do not disappear, during anti-TNF-α therapy. No overall changes in bone erosions or proliferations were observed. On joint-level baseline MRI, BMO was related to subsequent erosive progression detected by CT.Trial registration: ClinicalTrials.gov, http://clinicaltrials.gov/, NCT01465438.

KW - Adult

KW - Anti-Inflammatory Agents

KW - Antibodies, Monoclonal, Humanized

KW - Arthritis, Psoriatic

KW - Disease-Free Survival

KW - Female

KW - Hand Joints

KW - Humans

KW - Magnetic Resonance Imaging

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Synovitis

KW - Tomography, X-Ray Computed

KW - Treatment Outcome

U2 - 10.1093/rheumatology/ket426

DO - 10.1093/rheumatology/ket426

M3 - Journal article

C2 - 24369412

SN - 1462-0324

VL - 53

SP - 746

EP - 756

JO - Rheumatology (Oxford, England)

JF - Rheumatology (Oxford, England)

IS - 4

ER -