MRI in early rheumatoid arthritis: synovitis and bone marrow oedema are independent predictors of subsequent radiographic progression

Bøyesen, Pernille; Haavardsholm, Espen A; Østergaard, Mikkel; Heijde, Desirée van der; Sesseng, S.; Kvien, Tore K

doi:10.1136/ard.2009.123950

Cited by 128 publications

(72 citation statements)

References 18 publications

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“…This might explain that the timeintegrated level of CRP was correlated with radiographic progression and IL-6 was not. Previous studies showing a correlation between cumulative levels of systemic inflammation and joint destruction assessed cumulative CRP burden as a proxy of joint inflammation (23,24,33). Interestingly, our data suggested that the impact of systemic inflammation on radiologic progression was independent from joint inflammation.…”

Section: Discussionsupporting

confidence: 58%

Evaluation of Serum Interleukin‐6 Level as a Surrogate Marker of Synovial Inflammation and as a Factor of Structural Progression in Early Rheumatoid Arthritis: Results From a French National Multicenter Cohort

Baillet¹,

Gossec

Paternotte

et al. 2015

Arthritis Care & Research

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Objective. Interleukin-6 (IL-6) is a key cytokine in rheumatoid arthritis pathogenesis. We aimed to analyze the association between IL-6 serum levels and joint inflammation at baseline and the correlation of time-integrated IL-6 values with structural damage during the first 36 months of early arthritis. Methods. IL-6 was assessed by 2 different methods in 813 patients of the French early arthritis cohort ESPOIR (Etude et Suivi des Polyarthrites Indiff erenci ees R ecentes) over 36 months. IL-6 and C-reactive protein (CRP) changes were correlated to radiographic progression assessed by the total Sharp/van der Heijde score (SHS). Synovium inflammation was assessed in a subgroup of 126 patients by ultrasonography (US). The relationship between SHS change and IL-6 or CRP levels at baseline was investigated by a univariate regression and a multivariable analysis. A longitudinal model nested by visit and patient was conducted to assess the role of IL-6 on SHS at each visit. Results. At baseline, IL-6 was more strongly correlated with the swollen joint count than CRP level. In the univariate analysis, the time-integrated value of IL-6 was more strongly correlated with the swollen joint count and the variation of SHS than timeintegrated CRP level. Baseline IL-6 was not independently associated with SHS change. Longitudinal models nested by patient showed that IL-6 levels were associated with structural damage independently from the Disease Activity Score in 28 joints, smoking status, rheumatoid factor, and anti-citrullinated protein peptide antibody serology, treatments, and CRP levels. Conclusion. IL-6 level was a marker of US synovitis at baseline. Repeated measurements of IL-6 are associated with structural damage.

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Section: Discussionsupporting

confidence: 58%

Evaluation of Serum Interleukin‐6 Level as a Surrogate Marker of Synovial Inflammation and as a Factor of Structural Progression in Early Rheumatoid Arthritis: Results From a French National Multicenter Cohort

Baillet¹,

Gossec

Paternotte

et al. 2015

Arthritis Care & Research

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“…Синовит и отек костного мозга, выявляемые при МРТ, развиваются до появления новых эрозий, которые в последующем обна-руживаются при МРТ или рентгенологическом исследова-нии [10][11][12][13][14][15][16][17]. Было показано, что в участках кости, которые на МРТ выглядят как очаги отека кости или остеита, проис-ходит выраженная инфильтрация клетками воспаления, в том числе остеокластами [18].…”

Section: фгбу «ниир» рамн москваunclassified

Golimumab therapy-induced indicators of X-ray inflammation progression and magnitude according to magnetic resonance imaging evidence in patients with rheumatoid arthritis, ankylosing spondylitis, or psoriatic arthritis

Смирнов¹

2013

Modern Rheumatology Journal

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Голимумаб (ГЛМ) представляет собой новое человече-ское моноклональное антитело к фактору некроза опухоли α (ФНОα) с высокой аффинностью и специфичностью, свя-зывающееся с растворимым и трансмембранным фрагмен-тами ФНО. Действие ГЛМ при ревматоидном артрите (РА) изучалось в 3 больших клинических исследованиях III фа-зы, которые включали пациентов, ранее получавших или не получавших лечение различными лекарственными препа-ратами [1][2][3]. В исследование «Голимумаб до применения метотрексата (МТ) как препарата первой линии для лечения ревматоидного артрита с ранним началом заболевания» (GO-BEFORE) включали пациентов с активным РА, кото-рым не назначали лечение метотрексатом (МТ). В исследо-вание «Голимумаб при активном ревматоидном артрите, не-смотря на применение метотрексата» (GO-FORWARD) включали пациентов с активным РА, несмотря на лечение МТ. В исследование «Голимумаб у пациентов с активным ревматоидном артритом после лечения ингибиторами фак-тора некроза опухоли α» (GO-AFTER) включали пациентов с активным РА, которым ранее проводилось лечение инги-биторами ФНОα . Рентгенологическое прогрессирование являлось одной из первичных конечных точек в исследова-нии GO-BEFORE и вторичной конечной точкой в исследо-вании GO-FORWАRD; исследование GO-AFTER не преду-сматривало рентгенологические исследования.РА -прогрессирующее иммуноопосредованное воспа-лительное заболевание, которое при отсутствии лечения в ранних стадиях может привести к существенной утрате тру-С О В P E М Е Н Н А Я Р Е В М А Т О Л О Г И Я № 2 ' 1 3 О Б З О Р 75 В статье представлены данные о прогрессировании рентгенологических и магнитно-резонансных изменений в суставах кистей и стоп у больных ревматоидным артритом и псориатической артропатией и в осевом скелете у больных анкилозирующим спонди-литом при использовании голимумаба (ГЛМ). Показано, что терапия ГЛМ сдерживала прогрессирование структурных изменений в периферических суставах и позвоночнике. Наблюдалась значимая корреляция данных магнитно-резонансной томографии и кон-центрации уровня С-реактивного белка в крови.Ключевые слова : голимумаб, рентгенография, магнитно-резонансная томография, прогрессирование изменений, ревматоидный артрит, псориатическая артропатия, анкилозирующий The paper gives data on the progression of X-ray and magnetic resonance imaging changes in the hand and foot joints of patients with rheumatoid arthritis and psoriatic arthropathy and in the axial skeleton of those with ankylosing spondylitis when golimumab is used. Golimumab therapy is shown to retard the progression of structural changes in the peripheral joints and vertebral column. There is a significant correlation between magnetic resonance imaging evidence and blood C-reactive protein concentrations.Key words: golimumab, magnetic resonance imaging, progression of changes, rheumatoid arthritis, psoriatic arthropathy, ankylosing spondylitis. Contact: Aleksandr Viktorovich Smirnov smirale@mail.ru П о к а з а т е л и р е н т г е н о л о г и ч е с к о г о п р о г р е с с и р о в а н и я и в ы р а ж е н н о с т и в о...

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“…Various studies have reported that MRI pathology (synovitis, bone erosions or, most often, BME) of the wrist and MCP joints at disease onset in early RA predicts radiographic erosions [108,[126][127][128][129][130][131][132][133][134]. Some looked at the short-term predictive value of MRI after 1 year [108,126,128,130,131], whereas other studies had 2 [128,132], 3 [134], 5 [133], 6 [127], or 10 years [129] of follow-up.…”

Section: Prognosticationmentioning

confidence: 99%

“…Some looked at the short-term predictive value of MRI after 1 year [108,126,128,130,131], whereas other studies had 2 [128,132], 3 [134], 5 [133], 6 [127], or 10 years [129] of follow-up. All studies found MRI to be a highly significant predictor of radiographic erosions.…”

Section: Prognosticationmentioning

confidence: 99%

The impact of MRI on the clinical management of inflammatory arthritides

et al. 2011

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In the past two decades, MRI has gained a major role in research and clinical management of patients with inflammatory arthritides, particularly in spondyloarthritis (SpA), rheumatoid arthritis (RA), and osteoarthritis (OA). MRI is regarded as the most sensitive imaging modality for detecting early SpA in young patients with inflammatory back pain and normal radiographs of the sacroiliac joints. The recently published Assessment of SpondyloArthritis International Society classification criteria for axial SpA include for the first time a positive MRI demonstrating sacroiliitis as an imaging criterion indicative of SpA together with at least one clinical feature of SpA. Recent data show that systematic assessment of sacroiliitis displayed on MRI has much greater diagnostic utility than previously reported and highlight the diagnostic relevance of structural lesions. In RA, MRI has predictive value for the development of disease in new onset undifferentiated arthritis, and MR pathology at disease onset is a highly significant predictor of radiographic erosions. Consequently MRI has been credited with an important role in the new ACR/EULAR 2010 classification criteria for RA. In OA, bone marrow edema (BME) and synovitis may serve as biomarkers in interventional trials. Treatment interventions targeting BME and synovitis observed on MRI in inflammatory arthritides may have a disease-modifying effect as these lesions are potentially reversible and have been shown to be associated with structural progression. Research should focus on the prognostic significance of MRI lesions in larger cohorts and whether adding MRI to routine care improves clinical and radiographic outcome in patients with inflammatory arthritides.

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MRI in early rheumatoid arthritis: synovitis and bone marrow oedema are independent predictors of subsequent radiographic progression

Abstract: Both baseline and 1-year cumulative measures of MRI synovitis and bone marrow oedema independently predicted 3-year radiographic progression. These results confirm that MRI synovitis and MRI bone marrow oedema precede radiographic progression in patients with early RA.

Cited by 128 publications

References 18 publications

Evaluation of Serum Interleukin‐6 Level as a Surrogate Marker of Synovial Inflammation and as a Factor of Structural Progression in Early Rheumatoid Arthritis: Results From a French National Multicenter Cohort

Evaluation of Serum Interleukin‐6 Level as a Surrogate Marker of Synovial Inflammation and as a Factor of Structural Progression in Early Rheumatoid Arthritis: Results From a French National Multicenter Cohort

Golimumab therapy-induced indicators of X-ray inflammation progression and magnitude according to magnetic resonance imaging evidence in patients with rheumatoid arthritis, ankylosing spondylitis, or psoriatic arthritis

The impact of MRI on the clinical management of inflammatory arthritides

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