Comprehensive appraisal of magnetic resonance imaging findings in sustained rheumatoid arthritis remission: A substudy

Veena K. Ranganath; Kambiz Motamedi; Espen A. Haavardsholm; Paul Maranian; David Elashoff; Fiona McQueen; Erin L. Duffy; Joan M. Bathon; Jeffrey R. Curtis; Weiling Chen; Larry Moreland; James Louie; Sogol Amjadi; James O'Dell; Stacey S. Cofield; E. William St.clair; S. Louis Bridges; Harold E. Paulus

doi:10.1002/acr.22541

Comprehensive appraisal of magnetic resonance imaging findings in sustained rheumatoid arthritis remission: A substudy

Veena K. Ranganath, Kambiz Motamedi, Espen A. Haavardsholm, Paul Maranian, David Elashoff, Fiona McQueen, Erin L. Duffy, Joan M. Bathon, Jeffrey R. Curtis, Weiling Chen, Larry Moreland, James Louie, Sogol Amjadi, James O'Dell, Stacey S. Cofield, E. William St.clair, S. Louis Bridges, Harold E. Paulus

Research output: Contribution to journal › Article › peer-review

23 Scopus citations

Abstract

Objective To evaluate the effect of sustained American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) Boolean remission on residual joint inflammation assessed by magnetic resonance imaging (MRI) and to secondarily evaluate other clinical definitions of remission, within an early seropositive rheumatoid arthritis (RA) cohort. Methods A subcohort of 118 RA patients was enrolled from patients who completed the 2-year, double-blind randomized Treatment of Early Aggressive Rheumatoid Arthritis (TEAR) trial. Patients received a single contrast-enhanced 1.5T MRI of their most involved wrist. Two readers scored MRIs for synovitis, osteitis, tenosynovitis, and erosions. Clinical assessments were performed every 3 months during the trial and at time of MRI. Results The subcohort was 92% seropositive with mean age 51 years, duration 4.1 months, and Disease Activity Score in 28 joints using the erythrocyte sedimentation rate 5.8 at TEAR entry. Total MRI inflammatory scores (tenosynovitis-+-synovitis-+-osteitis) were lower among patients in clinical remission. Lower MRI scores were correlated with longer duration of Clinical Disease Activity Index (CDAI) remission (ρ-=-0.22, P-=-0.03). At the time of MRI, 89 patients had no wrist pain/tenderness/swelling; however, all 118 patients had MRI evidence of residual joint inflammation after 2 years. No statistically significant differences in damage or MRI inflammatory scores were observed across treatment groups. Conclusion This is the first detailed appraisal describing the relationship between clinical remission cut points and MRI inflammatory scores within an RA randomized controlled trial. The most stringent remission criteria (2011 ACR/EULAR and CDAI) best differentiate the total MRI inflammatory scores. These results document that 2 years of triple therapy or tumor necrosis factor plus methotrexate treatment in early RA does not eliminate MRI evidence of joint inflammation.

Original language	English (US)
Pages (from-to)	929-939
Number of pages	11
Journal	Arthritis Care and Research
Volume	67
Issue number	7
DOIs	https://doi.org/10.1002/acr.22541
State	Published - Jul 1 2015
Externally published	Yes

ASJC Scopus subject areas

Rheumatology

Access to Document

10.1002/acr.22541

Cite this

Ranganath, V. K., Motamedi, K., Haavardsholm, E. A., Maranian, P., Elashoff, D., McQueen, F., Duffy, E. L., Bathon, J. M., Curtis, J. R., Chen, W., Moreland, L., Louie, J., Amjadi, S., O'Dell, J., Cofield, S. S., St.clair, E. W., Bridges, S. L., & Paulus, H. E. (2015). Comprehensive appraisal of magnetic resonance imaging findings in sustained rheumatoid arthritis remission: A substudy. Arthritis Care and Research, 67(7), 929-939. https://doi.org/10.1002/acr.22541

Ranganath, VK, Motamedi, K, Haavardsholm, EA, Maranian, P, Elashoff, D, McQueen, F, Duffy, EL, Bathon, JM, Curtis, JR, Chen, W, Moreland, L, Louie, J, Amjadi, S, O'Dell, J, Cofield, SS, St.clair, EW, Bridges, SL & Paulus, HE 2015, 'Comprehensive appraisal of magnetic resonance imaging findings in sustained rheumatoid arthritis remission: A substudy', Arthritis Care and Research, vol. 67, no. 7, pp. 929-939. https://doi.org/10.1002/acr.22541

@article{d0dd7e57ae5049dfba6db51d40a8060d,

title = "Comprehensive appraisal of magnetic resonance imaging findings in sustained rheumatoid arthritis remission: A substudy",

abstract = "Objective To evaluate the effect of sustained American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) Boolean remission on residual joint inflammation assessed by magnetic resonance imaging (MRI) and to secondarily evaluate other clinical definitions of remission, within an early seropositive rheumatoid arthritis (RA) cohort. Methods A subcohort of 118 RA patients was enrolled from patients who completed the 2-year, double-blind randomized Treatment of Early Aggressive Rheumatoid Arthritis (TEAR) trial. Patients received a single contrast-enhanced 1.5T MRI of their most involved wrist. Two readers scored MRIs for synovitis, osteitis, tenosynovitis, and erosions. Clinical assessments were performed every 3 months during the trial and at time of MRI. Results The subcohort was 92% seropositive with mean age 51 years, duration 4.1 months, and Disease Activity Score in 28 joints using the erythrocyte sedimentation rate 5.8 at TEAR entry. Total MRI inflammatory scores (tenosynovitis-+-synovitis-+-osteitis) were lower among patients in clinical remission. Lower MRI scores were correlated with longer duration of Clinical Disease Activity Index (CDAI) remission (ρ-=-0.22, P-=-0.03). At the time of MRI, 89 patients had no wrist pain/tenderness/swelling; however, all 118 patients had MRI evidence of residual joint inflammation after 2 years. No statistically significant differences in damage or MRI inflammatory scores were observed across treatment groups. Conclusion This is the first detailed appraisal describing the relationship between clinical remission cut points and MRI inflammatory scores within an RA randomized controlled trial. The most stringent remission criteria (2011 ACR/EULAR and CDAI) best differentiate the total MRI inflammatory scores. These results document that 2 years of triple therapy or tumor necrosis factor plus methotrexate treatment in early RA does not eliminate MRI evidence of joint inflammation.",

author = "Ranganath, {Veena K.} and Kambiz Motamedi and Haavardsholm, {Espen A.} and Paul Maranian and David Elashoff and Fiona McQueen and Duffy, {Erin L.} and Bathon, {Joan M.} and Curtis, {Jeffrey R.} and Weiling Chen and Larry Moreland and James Louie and Sogol Amjadi and James O'Dell and Cofield, {Stacey S.} and St.clair, {E. William} and Bridges, {S. Louis} and Paulus, {Harold E.}",

year = "2015",

month = jul,

day = "1",

doi = "10.1002/acr.22541",

language = "English (US)",

volume = "67",

pages = "929--939",

journal = "Arthritis Care and Research",

issn = "2151-464X",

publisher = "John Wiley and Sons Ltd",

number = "7",

}

TY - JOUR

T1 - Comprehensive appraisal of magnetic resonance imaging findings in sustained rheumatoid arthritis remission

T2 - A substudy

AU - Ranganath, Veena K.

AU - Motamedi, Kambiz

AU - Haavardsholm, Espen A.

AU - Maranian, Paul

AU - Elashoff, David

AU - McQueen, Fiona

AU - Duffy, Erin L.

AU - Bathon, Joan M.

AU - Curtis, Jeffrey R.

AU - Chen, Weiling

AU - Moreland, Larry

AU - Louie, James

AU - Amjadi, Sogol

AU - O'Dell, James

AU - Cofield, Stacey S.

AU - St.clair, E. William

AU - Bridges, S. Louis

AU - Paulus, Harold E.

PY - 2015/7/1

Y1 - 2015/7/1

N2 - Objective To evaluate the effect of sustained American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) Boolean remission on residual joint inflammation assessed by magnetic resonance imaging (MRI) and to secondarily evaluate other clinical definitions of remission, within an early seropositive rheumatoid arthritis (RA) cohort. Methods A subcohort of 118 RA patients was enrolled from patients who completed the 2-year, double-blind randomized Treatment of Early Aggressive Rheumatoid Arthritis (TEAR) trial. Patients received a single contrast-enhanced 1.5T MRI of their most involved wrist. Two readers scored MRIs for synovitis, osteitis, tenosynovitis, and erosions. Clinical assessments were performed every 3 months during the trial and at time of MRI. Results The subcohort was 92% seropositive with mean age 51 years, duration 4.1 months, and Disease Activity Score in 28 joints using the erythrocyte sedimentation rate 5.8 at TEAR entry. Total MRI inflammatory scores (tenosynovitis-+-synovitis-+-osteitis) were lower among patients in clinical remission. Lower MRI scores were correlated with longer duration of Clinical Disease Activity Index (CDAI) remission (ρ-=-0.22, P-=-0.03). At the time of MRI, 89 patients had no wrist pain/tenderness/swelling; however, all 118 patients had MRI evidence of residual joint inflammation after 2 years. No statistically significant differences in damage or MRI inflammatory scores were observed across treatment groups. Conclusion This is the first detailed appraisal describing the relationship between clinical remission cut points and MRI inflammatory scores within an RA randomized controlled trial. The most stringent remission criteria (2011 ACR/EULAR and CDAI) best differentiate the total MRI inflammatory scores. These results document that 2 years of triple therapy or tumor necrosis factor plus methotrexate treatment in early RA does not eliminate MRI evidence of joint inflammation.

AB - Objective To evaluate the effect of sustained American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) Boolean remission on residual joint inflammation assessed by magnetic resonance imaging (MRI) and to secondarily evaluate other clinical definitions of remission, within an early seropositive rheumatoid arthritis (RA) cohort. Methods A subcohort of 118 RA patients was enrolled from patients who completed the 2-year, double-blind randomized Treatment of Early Aggressive Rheumatoid Arthritis (TEAR) trial. Patients received a single contrast-enhanced 1.5T MRI of their most involved wrist. Two readers scored MRIs for synovitis, osteitis, tenosynovitis, and erosions. Clinical assessments were performed every 3 months during the trial and at time of MRI. Results The subcohort was 92% seropositive with mean age 51 years, duration 4.1 months, and Disease Activity Score in 28 joints using the erythrocyte sedimentation rate 5.8 at TEAR entry. Total MRI inflammatory scores (tenosynovitis-+-synovitis-+-osteitis) were lower among patients in clinical remission. Lower MRI scores were correlated with longer duration of Clinical Disease Activity Index (CDAI) remission (ρ-=-0.22, P-=-0.03). At the time of MRI, 89 patients had no wrist pain/tenderness/swelling; however, all 118 patients had MRI evidence of residual joint inflammation after 2 years. No statistically significant differences in damage or MRI inflammatory scores were observed across treatment groups. Conclusion This is the first detailed appraisal describing the relationship between clinical remission cut points and MRI inflammatory scores within an RA randomized controlled trial. The most stringent remission criteria (2011 ACR/EULAR and CDAI) best differentiate the total MRI inflammatory scores. These results document that 2 years of triple therapy or tumor necrosis factor plus methotrexate treatment in early RA does not eliminate MRI evidence of joint inflammation.

UR - http://www.scopus.com/inward/record.url?scp=84932610086&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84932610086&partnerID=8YFLogxK

U2 - 10.1002/acr.22541

DO - 10.1002/acr.22541

M3 - Article

C2 - 25581612

AN - SCOPUS:84932610086

SN - 2151-464X

VL - 67

SP - 929

EP - 939

JO - Arthritis Care and Research

JF - Arthritis Care and Research

IS - 7

ER -

Comprehensive appraisal of magnetic resonance imaging findings in sustained rheumatoid arthritis remission: A substudy

Abstract

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this