Charles Peterfy1, Vibeke Strand2, Lu Tian3, Mikkel Østergaard4,5, Ying Lu3, Julie DiCarlo1, Peter Countryman1, Atul Deodhar6, Robert Landewé7,8, Veena K Ranganath9,10, Orrin Troum11,12, Philip G Conaghan13,14. 1. Spire Sciences, Inc., Boca Raton, Florida, USA. 2. Division of Immunology/Rheumatology, Stanford University, Palo Alto, California, USA. 3. Department of Biomedical Data Science, Stanford University, Palo Alto, California, USA. 4. Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup, Denmark. 5. Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. 6. Division of Arthritis & Rheumatic Diseases (OPO9), Oregon Health & Science University, Portland, Oregon, USA. 7. Amsterdam Rheumatology & Immunology Center (ARC)(AMC), Amsterdam, The Netherlands. 8. Zuyderland Medical Center, Heerlen, The Netherlands. 9. Division of Rheumatology, University of California, Los Angeles, California, USA. 10. David Geffen School of Medicine, Los Angeles, California, USA. 11. The Doctors of Saint John's Medical Group, Providence Saint John's Health Center, Santa Monica, California, USA. 12. Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. 13. Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK. 14. NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.
Abstract
OBJECTIVE: In rheumatoid arthritis (RA), MRI provides earlier detection of structural damage than radiography (X-ray) and more sensitive detection of intra-articular inflammation than clinical examination. This analysis was designed to evaluate the ability of early MRI findings to predict subsequent structural damage by X-ray. METHODS: Pooled data from four randomised controlled trials (RCTs) involving 1022 RA hands and wrists in early and established RA were analysed. X-rays were scored using van der Heijde-modified or Genant-modified Sharp methods. MRIs were scored using Outcome Measures in Rheumatology (OMERACT) RA MRI Score (RAMRIS). Data were analysed at the patient level using multivariable logistic regression and receiver operating characteristic curve analyses. RESULTS: Progression of MRI erosion scores at Weeks 12 and 24 predicted progression of X-ray erosions at Weeks 24 and 52, with areas under the curve (AUCs) of 0.64 and 0.74, respectively. 12-week and 24-week changes in MRI osteitis scores were similarly predictive of 24-week and 52-week X-ray erosion progressions; pooled AUCs were 0.78 and 0.77, respectively. MRI changes in synovitis at Weeks 12 and 24 also predicted progression of X-ray joint damage (erosion and joint-space narrowing) at Weeks 24 and 52 (AUCs=0.72 and 0.65, respectively). CONCLUSIONS: Early changes in joint damage and inflammation detected with MRI predict changes in joint damage evident on subsequent X-rays. These findings support the use of MRI as a valid method for monitoring structural damage in short-duration RCTs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
OBJECTIVE: In rheumatoid arthritis (RA), MRI provides earlier detection of structural damage than radiography (X-ray) and more sensitive detection of intra-articular inflammation than clinical examination. This analysis was designed to evaluate the ability of early MRI findings to predict subsequent structural damage by X-ray. METHODS: Pooled data from four randomised controlled trials (RCTs) involving 1022 RA hands and wrists in early and established RA were analysed. X-rays were scored using van der Heijde-modified or Genant-modified Sharp methods. MRIs were scored using Outcome Measures in Rheumatology (OMERACT) RA MRI Score (RAMRIS). Data were analysed at the patient level using multivariable logistic regression and receiver operating characteristic curve analyses. RESULTS: Progression of MRI erosion scores at Weeks 12 and 24 predicted progression of X-ray erosions at Weeks 24 and 52, with areas under the curve (AUCs) of 0.64 and 0.74, respectively. 12-week and 24-week changes in MRI osteitis scores were similarly predictive of 24-week and 52-week X-ray erosion progressions; pooled AUCs were 0.78 and 0.77, respectively. MRI changes in synovitis at Weeks 12 and 24 also predicted progression of X-ray joint damage (erosion and joint-space narrowing) at Weeks 24 and 52 (AUCs=0.72 and 0.65, respectively). CONCLUSIONS: Early changes in joint damage and inflammation detected with MRI predict changes in joint damage evident on subsequent X-rays. These findings support the use of MRI as a valid method for monitoring structural damage in short-duration RCTs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Entities:
Keywords:
Magnetic Resonance Imaging; Outcomes research; Rheumatoid Arthritis
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