No overall damage progression despite persistent inflammation in adalimumab-treated psoriatic arthritis patients: results from an investigator-initiated 48-week comparative magnetic resonance imaging, computed tomography and radiography trial
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No overall damage progression despite persistent inflammation in adalimumab-treated psoriatic arthritis patients : results from an investigator-initiated 48-week comparative magnetic resonance imaging, computed tomography and radiography trial. / Poggenborg, René Panduro; Wiell, Charlotte; Bøyesen, Pernille; Boonen, Annelies; Bird, Paul; Pedersen, Susanne Juhl; Sørensen, Inge Juul; Madsen, Ole Rintek; Slot, Ole; Møller, Jakob M; Hasselquist, Maria; Kubassova, Olga; Østergaard, Mikkel.
I: Rheumatology (Oxford, England), Bind 53, Nr. 4, 04.2014, s. 746-756.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - No overall damage progression despite persistent inflammation in adalimumab-treated psoriatic arthritis patients
T2 - results from an investigator-initiated 48-week comparative magnetic resonance imaging, computed tomography and radiography trial
AU - Poggenborg, René Panduro
AU - Wiell, Charlotte
AU - Bøyesen, Pernille
AU - Boonen, Annelies
AU - Bird, Paul
AU - Pedersen, Susanne Juhl
AU - Sørensen, Inge Juul
AU - Madsen, Ole Rintek
AU - Slot, Ole
AU - Møller, Jakob M
AU - Hasselquist, Maria
AU - Kubassova, Olga
AU - Østergaard, Mikkel
PY - 2014/4
Y1 - 2014/4
N2 - OBJECTIVE: In a comparative conventional MRI, dynamic contrast-enhanced (DCE)-MRI, CT and radiography study, the authors aimed to monitor whether inflammation is reduced or even eliminated and damage halted in PsA patients receiving anti-TNF therapy.METHODS: A 48-week prospective open-label investigator-initiated trial of 41 biologic-naive patients treated with 40 mg adalimumab every other week. Hand CT, MRI (according to the PsA MRI scoring system method) and radiography (Sharp-van der Heijde method) were obtained at weeks 0, 6 (only MRI), 24 and 48. Clinical response was assessed by the PsA Response Criteria (PsARC).RESULTS: In the 23 PsARC responders at week 48, significant decreases from baseline in MRI synovitis (mean -2.0, P < 0.05), bone marrow oedema (BMO) (-1.3, P < 0.05), flexor tenosynovitis (-2.1, P < 0.05) and total inflammation (-6.0, P < 0.005) were observed. However, MRI signs of inflammation remained present (week 48 total inflammation score median = 9). Several DCE-MRI parameters also decreased (P < 0.05) and were correlated (ρ = 0.62) with conventional MRI total inflammation score. No statistically significant changes in bone erosion or proliferation scores were observed. With CT as the standard reference for detecting bone erosions/proliferations, sensitivity, specificity and accuracy were 100%/40%, 83%/93% and 84%/86%, respectively, for MRI, whereas corresponding values for radiography were 17%/26%, 98%/96%, and 93%/87%, respectively. Erosive progression as assessed by CT was found in 6 of 480 joints and baseline BMO was predictive (relative risk 10, 95% CI 2.1, 49).CONCLUSION: MRI signs of inflammation decrease, but do not disappear, during anti-TNF-α therapy. No overall changes in bone erosions or proliferations were observed. On joint-level baseline MRI, BMO was related to subsequent erosive progression detected by CT.TRIAL REGISTRATION: ClinicalTrials.gov, http://clinicaltrials.gov/, NCT01465438.
AB - OBJECTIVE: In a comparative conventional MRI, dynamic contrast-enhanced (DCE)-MRI, CT and radiography study, the authors aimed to monitor whether inflammation is reduced or even eliminated and damage halted in PsA patients receiving anti-TNF therapy.METHODS: A 48-week prospective open-label investigator-initiated trial of 41 biologic-naive patients treated with 40 mg adalimumab every other week. Hand CT, MRI (according to the PsA MRI scoring system method) and radiography (Sharp-van der Heijde method) were obtained at weeks 0, 6 (only MRI), 24 and 48. Clinical response was assessed by the PsA Response Criteria (PsARC).RESULTS: In the 23 PsARC responders at week 48, significant decreases from baseline in MRI synovitis (mean -2.0, P < 0.05), bone marrow oedema (BMO) (-1.3, P < 0.05), flexor tenosynovitis (-2.1, P < 0.05) and total inflammation (-6.0, P < 0.005) were observed. However, MRI signs of inflammation remained present (week 48 total inflammation score median = 9). Several DCE-MRI parameters also decreased (P < 0.05) and were correlated (ρ = 0.62) with conventional MRI total inflammation score. No statistically significant changes in bone erosion or proliferation scores were observed. With CT as the standard reference for detecting bone erosions/proliferations, sensitivity, specificity and accuracy were 100%/40%, 83%/93% and 84%/86%, respectively, for MRI, whereas corresponding values for radiography were 17%/26%, 98%/96%, and 93%/87%, respectively. Erosive progression as assessed by CT was found in 6 of 480 joints and baseline BMO was predictive (relative risk 10, 95% CI 2.1, 49).CONCLUSION: MRI signs of inflammation decrease, but do not disappear, during anti-TNF-α therapy. No overall changes in bone erosions or proliferations were observed. On joint-level baseline MRI, BMO was related to subsequent erosive progression detected by CT.TRIAL REGISTRATION: ClinicalTrials.gov, http://clinicaltrials.gov/, NCT01465438.
KW - Adult
KW - Anti-Inflammatory Agents
KW - Antibodies, Monoclonal, Humanized
KW - Arthritis, Psoriatic
KW - Disease-Free Survival
KW - Female
KW - Hand Joints
KW - Humans
KW - Magnetic Resonance Imaging
KW - Male
KW - Middle Aged
KW - Prospective Studies
KW - Synovitis
KW - Tomography, X-Ray Computed
KW - Treatment Outcome
U2 - 10.1093/rheumatology/ket426
DO - 10.1093/rheumatology/ket426
M3 - Journal article
C2 - 24369412
VL - 53
SP - 746
EP - 756
JO - Rheumatology
JF - Rheumatology
SN - 1462-0324
IS - 4
ER -
ID: 138227082