Magnetic Resonance Imaging Bone Edema at Enrollment Predicts Rapid Radiographic Progression in Patients with Early RA: Results from the Nagasaki University Early Arthritis Cohort

Abstract

Our findings suggest that MRI bone edema is closely associated with the development of RRP in patients with early-stage RA. Physicians should carefully control the disease activity when MRI bone edema is observed in patients with early RA.

Baseline MRI bone erosion predicts the subsequent radiographic progression in early rheumatoid arthritis patients who achieved sustained good clinical response

“…The RAMRIS scores of synovitis, bone edema and bone erosion were scored by consensus opinion by two experienced radiologists. The inter-and intra-observer reliability levels of the RAMRIS synovitis, bone edema and bone erosion scores were 0.80, 0.85, and 0.81, and 0.88, 0.92, and 0.86, respectively, which was considered to be sufficiently high [17].…”

“…We examined MRIs of both the wrists and finger joints of the study subjects, as all subjects expressed joint symptoms of the wrist and finger joints at enrollment. The clinical diagnosis of RA (reference standard RA) of the 95 subjects was made based on both their fulfilling the 2010 ACR/EULAR classification for RA and undergoing the administration of DMARDs within the firstyear, as we recently described [17]. Full data sets were available for 76 of the 95 patients.…”

“…The Nagasaki early arthritis cohort opened in 2001 as part of the Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences [17,[24][25][26][27]. The patients in this cohort are referred from an area in the western part of Japan, Nagasaki Prefecture, which has approx.…”

“…The DMARDs administered within the first year in these 76 patients were as The baseline clinical manifestations and variables included gender, age, disease duration from onset to entry, morning stiffness, DMARDs, glucocorticoid, DAS28-CRP, CRP (measured by latex turbidimetric immunosorbent assay; Daiichi Pure Chemicals, Fukuoka, Japan), matrix metalloproteinase 3 (MMP-3; measured by enzyme-linked immunosorbent assay [ELISA]; the cut-off value was 59.7 ng/mL for females and 121.0 ng/mL for males; Daiichi Pure Chemicals), anti-cyclic citrullinated peptide antibodies (ACPA) (measured by ELISA, with a cut-off value of 4.5 U/mL; DIASTAT Anti-CCP; Axis-Shield, Dundee, UK), rheumatoid factor (RF) (measured by latex-enhanced immunonephelometric assay, with a cut-off value of 14 IU/mL; Dade Behring, Marburg, Germany), MRI synovitis, MRI bone edema, MRI bone erosion, and plain radiographs. All variables were examined on the same day, as described previously [17,[24][25][26][27].…”

“…In this regard, we recently revealed that MRI bone edema at baseline is closely associated with the development of rapid radiographic progression (RRP) in patients with active early-stage RA among the Nagasaki University Early Arthritis Cohort [17].…”