Daniel Glinatsi1, Paul Bird2, Frederique Gandjbakhch2, Philip J Mease2, Pernille Bøyesen2, Charles G Peterfy2, Philip G Conaghan2, Mikkel Østergaard2. 1. From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, University of Copenhagen; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of NSW, Sydney, Australia; Pitié Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Swedish Medical Center and University of Washington, Seattle, Washington, USA; Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences Inc., Boca Raton, Florida, USA; and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.D. Glinatsi, MD, Research Fellow, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié Salpêtrière Hospital, APHP, Université Paris 6-UPMC; P.J. Mease, MD, Swedish Medical Center and University of Washington; P. Bøyesen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup and Department of Clinical Medicine, University of Copenhagen. daniel.glinatsi@gmail.com daniel.erik.malm@regionh.dk. 2. From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, University of Copenhagen; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of NSW, Sydney, Australia; Pitié Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Swedish Medical Center and University of Washington, Seattle, Washington, USA; Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences Inc., Boca Raton, Florida, USA; and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.D. Glinatsi, MD, Research Fellow, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié Salpêtrière Hospital, APHP, Université Paris 6-UPMC; P.J. Mease, MD, Swedish Medical Center and University of Washington; P. Bøyesen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup and Department of Clinical Medicine, University of Copenhagen.
Abstract
OBJECTIVE: To assess changes following treatment and the reliability and responsiveness to change of the Outcome Measures in Rheumatology (OMERACT) Psoriatic Arthritis Magnetic Resonance Imaging Score (PsAMRIS) in a randomized controlled trial. METHODS: Forty patients with PsA randomized to either placebo or abatacept (ABA) had MRI of either 1 hand (n = 20) or 1 foot (n = 20) at baseline and after 6 months. Images were scored blindly twice by 3 independent readers according to the PsAMRIS (for synovitis, tenosynovitis, periarticular inflammation, bone edema, bone erosion, and bone proliferation). RESULTS: Inflammatory features improved numerically but statistically nonsignificantly in the ABA group but not the placebo group. Baseline intrareader intraclass correlation coefficients (ICC) were good (≥ 0.50) to very good (≥ 0.80) for all features in both hand and foot. Baseline interreader ICC were good (ICC 0.72-0.96) for all features, except periarticular inflammation and bone proliferation in the hand and tenosynovitis in the foot (ICC 0.25-0.44). Intrareader and interreader ICC for change scores varied. Guyatt's responsiveness index (GRI) was high for inflammatory features in the hand and metatarsophalangeal joints (GRI -0.67 to -3.13; bone edema not calculable). Minimal change and low prevalence resulted in low ICC and GRI for bone damage. CONCLUSION: PsAMRIS showed overall good intrareader agreement in the hand and foot, and inflammatory feature scores were responsive to change, suggesting that PsAMRIS may be a valid tool for MRI assessment of hands and feet in PsA clinical trials.
OBJECTIVE: To assess changes following treatment and the reliability and responsiveness to change of the Outcome Measures in Rheumatology (OMERACT) Psoriatic Arthritis Magnetic Resonance Imaging Score (PsAMRIS) in a randomized controlled trial. METHODS: Forty patients with PsA randomized to either placebo or abatacept (ABA) had MRI of either 1 hand (n = 20) or 1 foot (n = 20) at baseline and after 6 months. Images were scored blindly twice by 3 independent readers according to the PsAMRIS (for synovitis, tenosynovitis, periarticular inflammation, bone edema, bone erosion, and bone proliferation). RESULTS: Inflammatory features improved numerically but statistically nonsignificantly in the ABA group but not the placebo group. Baseline intrareader intraclass correlation coefficients (ICC) were good (≥ 0.50) to very good (≥ 0.80) for all features in both hand and foot. Baseline interreader ICC were good (ICC 0.72-0.96) for all features, except periarticular inflammation and bone proliferation in the hand and tenosynovitis in the foot (ICC 0.25-0.44). Intrareader and interreader ICC for change scores varied. Guyatt's responsiveness index (GRI) was high for inflammatory features in the hand and metatarsophalangeal joints (GRI -0.67 to -3.13; bone edema not calculable). Minimal change and low prevalence resulted in low ICC and GRI for bone damage. CONCLUSION: PsAMRIS showed overall good intrareader agreement in the hand and foot, and inflammatory feature scores were responsive to change, suggesting that PsAMRIS may be a valid tool for MRI assessment of hands and feet in PsA clinical trials.
Entities:
Keywords:
MAGNETIC RESONANCE IMAGING; OMERACT; PSORIATIC ARTHRITIS; PsAMRIS
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