Mami Tamai1, Kazuhiko Arima2, Yoshikazu Nakashima1, Junko Kita1, Masataka Umeda1, Shoichi Fukui1, Ayako Nishino1, Takahisa Suzuki1,2, Yoshiro Horai1, Akitomo Okada1,3, Tomohiro Koga1, Shin-Ya Kawashiri1,4, Naoki Iwamoto1, Kunihiro Ichinose1, Satoshi Yamasaki5, Hideki Nakamura1, Tomoki Origuchi1,6, Kiyoshi Aoyagi2, Masataka Uetani7, Katsumi Eguchi1,8, Atsushi Kawakami1. 1. a Department of Immunology and Rheumatology , Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan. 2. b Department of Public Health , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan. 3. c Department of Rheumatology , Japanese Red Cross Nagasaki Genbaku Hospital , Nagasaki , Japan. 4. d Department of Community Medicine , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan. 5. e Division of Rheumatology , Kurume University Medical Center , Kurume , Japan. 6. f Department of Locomotive and Rehabilitation Sciences , Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University , Nagasaki , Japan. 7. g Department of Radiological Sciences , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan. 8. h Department of Rheumatology , Sasebo Chuo Hospital , Sasebo , Japan.
Abstract
OBJECTIVE: To examine whether magnetic resonance imaging (MRI) findings at baseline predict radiographic progression in early-stage rheumatoid arthritis (RA) patients who have achieved sustained good clinical response. METHODS: This is a sub-analysis from the one-year observational study of Nagasaki University Early Arthritis Cohort. Definition of 'good clinical response' was a decrement of disease activity score (DAS) 28 ≧ 1.2 at three months with achievement of DAS28 remission through 6-12 months. Gd-enhanced MRI of both wrists and finger joints were examined at baseline and scored using rheumatoid arthritis magnetic resonance imaging score (RAMRIS). Annual increment of Genant-modified Sharp score (GSS) > 0 was defined as 'radiographic progression'. Predictors of radiographic progression were determined by logistic regression analysis. RESULTS: Twenty-four subjects were selected in the present study. Each median RAMRIS synovitis, bone edema, bone erosion, and GSS at baseline were 6.5, 0.5, 0, and 0, respectively. Five patients developed radiographic progression at one year. Multivariate logistic regression analysis has shown that RAMRIS bone erosion at baseline is the only independent predictor of radiographic progression at one year (p = .032). CONCLUSIONS: Our data suggest that MRI bone erosion predicts poor radiographic outcome of early-stage RA even if it has been successfully treated.
OBJECTIVE: To examine whether magnetic resonance imaging (MRI) findings at baseline predict radiographic progression in early-stage rheumatoid arthritis (RA) patients who have achieved sustained good clinical response. METHODS: This is a sub-analysis from the one-year observational study of Nagasaki University Early Arthritis Cohort. Definition of 'good clinical response' was a decrement of disease activity score (DAS) 28 ≧ 1.2 at three months with achievement of DAS28 remission through 6-12 months. Gd-enhanced MRI of both wrists and finger joints were examined at baseline and scored using rheumatoid arthritis magnetic resonance imaging score (RAMRIS). Annual increment of Genant-modified Sharp score (GSS) > 0 was defined as 'radiographic progression'. Predictors of radiographic progression were determined by logistic regression analysis. RESULTS: Twenty-four subjects were selected in the present study. Each median RAMRIS synovitis, bone edema, bone erosion, and GSS at baseline were 6.5, 0.5, 0, and 0, respectively. Five patients developed radiographic progression at one year. Multivariate logistic regression analysis has shown that RAMRIS bone erosion at baseline is the only independent predictor of radiographic progression at one year (p = .032). CONCLUSIONS: Our data suggest that MRI bone erosion predicts poor radiographic outcome of early-stage RA even if it has been successfully treated.
Authors: Paul Bird; Charles Peterfy; Peter Countryman; Hedley Griffiths; Rina Barrett; Peter Youssef; Fredrick Joshua; Stephen Hall Journal: Int J Rheumatol Date: 2018-04-12