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Comprehensive appraisal of magnetic resonance imaging findings in sustained rheumatoid arthritis remission: a substudy.

Publication ,  Journal Article
Ranganath, VK; Motamedi, K; Haavardsholm, EA; Maranian, P; Elashoff, D; McQueen, F; Duffy, EL; Bathon, JM; Curtis, JR; Chen, W; Moreland, L ...
Published in: Arthritis Care Res (Hoboken)
July 2015

OBJECTIVE: To evaluate the effect of sustained American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) Boolean remission on residual joint inflammation assessed by magnetic resonance imaging (MRI) and to secondarily evaluate other clinical definitions of remission, within an early seropositive rheumatoid arthritis (RA) cohort. METHODS: A subcohort of 118 RA patients was enrolled from patients who completed the 2-year, double-blind randomized Treatment of Early Aggressive Rheumatoid Arthritis (TEAR) trial. Patients received a single contrast-enhanced 1.5T MRI of their most involved wrist. Two readers scored MRIs for synovitis, osteitis, tenosynovitis, and erosions. Clinical assessments were performed every 3 months during the trial and at time of MRI. RESULTS: The subcohort was 92% seropositive with mean age 51 years, duration 4.1 months, and Disease Activity Score in 28 joints using the erythrocyte sedimentation rate 5.8 at TEAR entry. Total MRI inflammatory scores (tenosynovitis + synovitis + osteitis) were lower among patients in clinical remission. Lower MRI scores were correlated with longer duration of Clinical Disease Activity Index (CDAI) remission (ρ = 0.22, P = 0.03). At the time of MRI, 89 patients had no wrist pain/tenderness/swelling; however, all 118 patients had MRI evidence of residual joint inflammation after 2 years. No statistically significant differences in damage or MRI inflammatory scores were observed across treatment groups. CONCLUSION: This is the first detailed appraisal describing the relationship between clinical remission cut points and MRI inflammatory scores within an RA randomized controlled trial. The most stringent remission criteria (2011 ACR/EULAR and CDAI) best differentiate the total MRI inflammatory scores. These results document that 2 years of triple therapy or tumor necrosis factor plus methotrexate treatment in early RA does not eliminate MRI evidence of joint inflammation.

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Published In

Arthritis Care Res (Hoboken)

DOI

EISSN

2151-4658

Publication Date

July 2015

Volume

67

Issue

7

Start / End Page

929 / 939

Location

United States

Related Subject Headings

  • Remission Induction
  • Male
  • Magnetic Resonance Imaging
  • Humans
  • Female
  • Double-Blind Method
  • Cohort Studies
  • Arthritis, Rheumatoid
  • Antirheumatic Agents
  • Adult
 

Citation

APA
Chicago
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MLA
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Ranganath, V. K., Motamedi, K., Haavardsholm, E. A., Maranian, P., Elashoff, D., McQueen, F., … Paulus, H. E. (2015). Comprehensive appraisal of magnetic resonance imaging findings in sustained rheumatoid arthritis remission: a substudy. Arthritis Care Res (Hoboken), 67(7), 929–939. https://doi.org/10.1002/acr.22541
Ranganath, Veena K., Kambiz Motamedi, Espen A. Haavardsholm, Paul Maranian, David Elashoff, Fiona McQueen, Erin L. Duffy, et al. “Comprehensive appraisal of magnetic resonance imaging findings in sustained rheumatoid arthritis remission: a substudy.Arthritis Care Res (Hoboken) 67, no. 7 (July 2015): 929–39. https://doi.org/10.1002/acr.22541.
Ranganath VK, Motamedi K, Haavardsholm EA, Maranian P, Elashoff D, McQueen F, et al. Comprehensive appraisal of magnetic resonance imaging findings in sustained rheumatoid arthritis remission: a substudy. Arthritis Care Res (Hoboken). 2015 Jul;67(7):929–39.
Ranganath, Veena K., et al. “Comprehensive appraisal of magnetic resonance imaging findings in sustained rheumatoid arthritis remission: a substudy.Arthritis Care Res (Hoboken), vol. 67, no. 7, July 2015, pp. 929–39. Pubmed, doi:10.1002/acr.22541.
Ranganath VK, Motamedi K, Haavardsholm EA, Maranian P, Elashoff D, McQueen F, Duffy EL, Bathon JM, Curtis JR, Chen W, Moreland L, Louie J, Amjadi S, O’Dell J, Cofield SS, St Clair EW, Bridges SL, Paulus HE. Comprehensive appraisal of magnetic resonance imaging findings in sustained rheumatoid arthritis remission: a substudy. Arthritis Care Res (Hoboken). 2015 Jul;67(7):929–939.
Journal cover image

Published In

Arthritis Care Res (Hoboken)

DOI

EISSN

2151-4658

Publication Date

July 2015

Volume

67

Issue

7

Start / End Page

929 / 939

Location

United States

Related Subject Headings

  • Remission Induction
  • Male
  • Magnetic Resonance Imaging
  • Humans
  • Female
  • Double-Blind Method
  • Cohort Studies
  • Arthritis, Rheumatoid
  • Antirheumatic Agents
  • Adult