Subclinical inflammation with tocilizumab treatment of rheumatoid arthritis: MRI evaluation for 2 years

Suzuki, Takeshi; Hirota, Tomoya; Ogishima, Hiroshi; Umeda, N.; Kondo, Yuya; Yokosawa, Masahiro; Miki, Haruka; Tsuboi, Hiroto; Matsumoto, Isao; Sumida, Takayuki

doi:10.1111/1756-185x.12460

Cited by 2 publications

(3 citation statements)

References 14 publications

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“…Currently, the chief aim of treatment for patients with RA is to achieve a state of disease remission or low levels of disease activity and stop progression of structural damage [ 6 ]. However, RA still has different degrees of subclinical arthritis in the clinical remission period, which is one of the important factors in the development of RA disease [ 7 , 8 ]. Therefore, how to find subclinical arthritis to help improve clinical treatment plan, effectively delay the occurrence of bone destruction, and improve the quality of life of patients is of great significance.…”

Section: Introductionmentioning

confidence: 99%

The application value of MRI in the diagnosis of subclinical inflammation in patients with rheumatoid arthritis in remission

Zhang

Chen

et al. 2018

J Orthop Surg Res

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BackgroundTo explore the value of MRI in the diagnosis of subclinical inflammation in patients with early rheumatoid arthritis (RA) in remission and to predict the radiographic progression.MethodsA total of 76 of 156 patients with early RA in remission at 1 year and with available magnetic resonance imaging (MRI) data at baseline and at 12 months were included. Complete clinical and laboratory evaluations were conducted for the patients. MRI images were assessed according to the Rheumatoid Arthritis Magnetic Resonance Imaging Scoring (RAMRIS) system. Progression of bone erosions was defined as an increase of 1 or more units in annual RAMRIS score for erosions compared to baseline.ResultsAt 1 year, the majority of patients with RA in sustained remission showed some inflammatory activity on MRI (43.4% synovitis, 39.5% bone marrow edema (BME), and 9.2% tenosynovitis), and 25 of the 76 patients (32.9%) showed MRI progression of bone erosions. A significant difference was observed in MRI BME and bone erosion at 1 year, with higher mean score in patients with progression compared to non-progression of erosions (BME, 4.8 ± 3.6 vs 3.1 ± 2.1, P = 0.01; bone erosion, 13.5 ± 9.6 vs 4.4 ± 3.6, P < 0.001).ConclusionPersistent subclinical inflammations were shown in patients with sustained remission; BME in MRI may be a strong predictor of future radiographic progression of bone erosions in patients with persistent clinical remission.

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Section: Introductionmentioning

confidence: 99%

The application value of MRI in the diagnosis of subclinical inflammation in patients with rheumatoid arthritis in remission

Zhang

Chen

et al. 2018

J Orthop Surg Res

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“…However, biological agents have significantly reduced disease activity by suppressing synovitis and reducing subsequent joint destruction 7 8. Among the biological agents, tocilizumab has been shown to fully inhibit the effect of interleukin-6 (IL-6) and C reactive protein (CRP) production,9 thereby leading to decreases in CRP and erythrocyte sedimentation rate (ESR). Musculoskeletal ultrasound has been used to evaluate the efficacy of drug treatment in RA.…”

Section: Introductionmentioning

confidence: 99%

“…However, biological agents have significantly reduced disease activity by suppressing synovitis and reducing subsequent joint destruction. 7 8 Among the biological agents, tocilizumab has been shown to fully inhibit the effect of interleukin-6 (IL-6) and C reactive protein (CRP) production, 9…”

Section: Introductionmentioning

confidence: 99%

Ultrasound is More Reliable than Inflammatory Parameters to Evaluate Disease Activity in Patients with Ra Receiving Tocilizumab Therapy

Chiu

Lai

et al. 2018

Journal of Investigative Medicine

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The target of treatment for rheumatoid arthritis (RA) is to keep low disease activity or remission. Tocilizumab can fully inhibit interleukin-6 and C reactive protein (CRP) production. The goal of the study is to search whether tocilizumab treatment compared with adalimumab treatment had the similar effect on sonography and inflammatory parameters in patients with RA. We compared ultrasound scores and inflammatory parameters between patients with RA receiving tocilizumab therapy and those receiving adalimumab therapy. Power Doppler (PD) ultrasound and grayscale synovial hypertrophy on bilateral radiocarpal joints were performed. Inflammatory mediators and ultrasound scores were compared by independent t-test between the adalimumab and tocilizumab groups. 65 patients with RA (32 tocilizumab and 33 adalimumab) were included. Between the two groups, there were no significant differences in age, gender, rheumatoid factors and anticyclic citrullinated peptide antibody. Following biological therapy, the ultrasound score was 2.33 in the tocilizumab group and 2.08 in the adalimumab group (p=0.570), while the erythrocyte sedimentation rate, CRP and Disease Activity Score in 28 joints (DAS28) were lower in the tocilizumab group. So ultrasound scores between the two groups were not significantly different, but the laboratory parameters and DAS28 were lower in the tocilizumab group than in the adalimumab group. Hence, to assess disease activity cannot be based only on clinical evaluations, so we suggest PD ultrasound to be used for all patients on tocilizumab therapy and reflect the true disease activity in these patients.

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Subclinical inflammation with tocilizumab treatment of rheumatoid arthritis: MRI evaluation for 2 years

Cited by 2 publications

References 14 publications

The application value of MRI in the diagnosis of subclinical inflammation in patients with rheumatoid arthritis in remission

The application value of MRI in the diagnosis of subclinical inflammation in patients with rheumatoid arthritis in remission

Ultrasound is More Reliable than Inflammatory Parameters to Evaluate Disease Activity in Patients with Ra Receiving Tocilizumab Therapy

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