Joshua F Baker1, Mikkel Østergaard2, Paul Emery3, Daniel G Baker4, Philip G Conaghan3. 1. Philadelphia Veterans Affairs Medical Center; University of Pennsylvania, School of Medicine; and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, USA. bakerjo@uphs.upenn.edu. 2. Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup; and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark. 3. Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK. 4. Janssen Research & Development, LLC., Horsham PA, USA.
Abstract
OBJECTIVES: To determine thresholds for rheumatoid arthritis (RA) magnetic resonance imaging scores (RAMRIS) associated with a low risk of structural damage progression. METHODS: MRI of the dominant hand was performed and RAMRIS scores determined at weeks 0, 24, and 52. X-rays were performed and van der Heijde-Sharp scores (vdHS) determined. In a development cohort (n=297) the changes in MRI erosion score and vdHS score were determined over the 24-week to 52-week interval and progression was defined as change >0.5. We identified 24-week thresholds for synovitis and osteitis that provided >90% sensitivity for imaging progression over the 24 to 52-week interval. The performance of these cut-offs was tested in a validation cohort (n=217). RESULTS: In the development cohort, synovitis or osteitis scores ≤3 by 24 weeks were associated with a low probability of progression on MRI and x-ray. The coefficient for osteitis was stronger than that of synovitis in models predicting x-ray and MRI progression. Therefore, a total inflammation score was weighted on osteitis (x2). An inflammation score ≤9 was more frequently attained than DAS28 remission (64 vs. 38) and was associated with low probability of progression regardless of attainment of clinical remission. In the validation cohort, there was a low odds of MRI progression among those with low synovitis [OR 0.27 (0.086,0.82) p=0.02], osteitis [OR 0.20 (0.085, 0.49) p<0.001] and inflammation scores [OR 0.12 (0.033, 0.41) p=0.001]. CONCLUSIONS: Attainment of low MRI single-hand synovitis and osteitis is not uncommon and predicts a lack of structural progression in RA, independent of clinical remission.
OBJECTIVES: To determine thresholds for rheumatoid arthritis (RA) magnetic resonance imaging scores (RAMRIS) associated with a low risk of structural damage progression. METHODS: MRI of the dominant hand was performed and RAMRIS scores determined at weeks 0, 24, and 52. X-rays were performed and van der Heijde-Sharp scores (vdHS) determined. In a development cohort (n=297) the changes in MRI erosion score and vdHS score were determined over the 24-week to 52-week interval and progression was defined as change >0.5. We identified 24-week thresholds for synovitis and osteitis that provided >90% sensitivity for imaging progression over the 24 to 52-week interval. The performance of these cut-offs was tested in a validation cohort (n=217). RESULTS: In the development cohort, synovitis or osteitis scores ≤3 by 24 weeks were associated with a low probability of progression on MRI and x-ray. The coefficient for osteitis was stronger than that of synovitis in models predicting x-ray and MRI progression. Therefore, a total inflammation score was weighted on osteitis (x2). An inflammation score ≤9 was more frequently attained than DAS28 remission (64 vs. 38) and was associated with low probability of progression regardless of attainment of clinical remission. In the validation cohort, there was a low odds of MRI progression among those with low synovitis [OR 0.27 (0.086,0.82) p=0.02], osteitis [OR 0.20 (0.085, 0.49) p<0.001] and inflammation scores [OR 0.12 (0.033, 0.41) p=0.001]. CONCLUSIONS: Attainment of low MRI single-hand synovitis and osteitis is not uncommon and predicts a lack of structural progression in RA, independent of clinical remission.
Authors: Carson Maynard; Ted R Mikuls; Grant W Cannon; Bryant R England; Philip G Conaghan; Mikkel Østergaard; Daniel G Baker; Gail Kerr; Michael D George; Jennifer L Barton; Joshua F Baker Journal: Arthritis Care Res (Hoboken) Date: 2020-03 Impact factor: 4.794
Authors: Harris A Ahmad; Joshua F Baker; Mikkel Østergaard; June Ye; Paul Emery; Philip G Conaghan Journal: Adv Ther Date: 2019-07-05 Impact factor: 3.845
Authors: Harris A Ahmad; Joshua F Baker; Philip G Conaghan; Paul Emery; Thomas W J Huizinga; Yedid Elbez; Subhashis Banerjee; Mikkel Østergaard Journal: Arthritis Res Ther Date: 2022-02-16 Impact factor: 5.156
Authors: Xenofon Baraliakos; Philip G Conaghan; Maria-Antonietta D'Agostino; Walter Maksymowych; Esperanza Naredo; Mikkel Ostergaard; Georg Schett; Paul Emery Journal: Eur J Rheumatol Date: 2019-01