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Research ArticleArticle

Evaluation of Magnetic Resonance Imaging Responsiveness in Active Psoriatic Arthritis at Multiple Timepoints during the First 12 Weeks of Antitumor Necrosis Factor Therapy

Marie Feletar, Stephen Hall and Paul Bird
The Journal of Rheumatology January 2016, 43 (1) 75-80; DOI: https://doi.org/10.3899/jrheum.150347
Marie Feletar
From the Department of Rheumatology, Emeritus Research, Victoria; Department of Rheumatology, Institution for Rehabilitation Research, University of Melbourne, Melbourne; Department of Medicine, University of New South Wales, Sydney, Australia.
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Stephen Hall
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Paul Bird
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  • For correspondence: pbird@optimusresearch.com.au
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Abstract

Objective. To assess the responsiveness of high- and low-field extremity magnetic resonance imaging (MRI) variables at multiple timepoints in the first 12 weeks post-antitumor necrosis factor (anti-TNF) therapy initiation in patients with psoriatic arthritis (PsA) and active dactylitis.

Methods. Twelve patients with active PsA and clinical evidence of dactylitis involving at least 1 digit were recruited. Patients underwent sequential high-field conventional (1.5 Tesla) and extremity low-field MRI (0.2 Tesla) of the affected hand or foot, pre- and postgadolinium at baseline (pre-TNF), 2 weeks (post-TNF), 6 weeks, and 12 weeks. A blinded observer scored all images on 2 occasions using the PsA MRI scoring system.

Results. Eleven patients completed the study, but only 6 patients completed all high-field and low-field MRI assessments. MRI scores demonstrated rapid response to TNF inhibition with score reduction in tenosynovitis, synovitis, and osteitis at 2 weeks. Intraobserver reliability was good to excellent for all variables. High-field MRI demonstrated greater sensitivity to tenosynovitis, synovitis, and osteitis and greater responsiveness to change posttreatment. Treatment responses were maintained to 12 weeks.

Conclusion. This study demonstrates the use of MRI in detecting early response to biologic therapy. MRI variables of tenosynovitis, synovitis, and osteitis demonstrated responsiveness posttherapy with high-field scores more responsive to change than low-field scores.

Key Indexing Terms:
  • PSORIATIC ARTHRITIS
  • MAGNETIC RESONANCE IMAGING
  • PsAMRIS
  • DACTYLITIS
  • Accepted for publication July 27, 2015.
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The Journal of Rheumatology
Vol. 43, Issue 1
1 Jan 2016
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Evaluation of Magnetic Resonance Imaging Responsiveness in Active Psoriatic Arthritis at Multiple Timepoints during the First 12 Weeks of Antitumor Necrosis Factor Therapy
Marie Feletar, Stephen Hall, Paul Bird
The Journal of Rheumatology Jan 2016, 43 (1) 75-80; DOI: 10.3899/jrheum.150347

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Evaluation of Magnetic Resonance Imaging Responsiveness in Active Psoriatic Arthritis at Multiple Timepoints during the First 12 Weeks of Antitumor Necrosis Factor Therapy
Marie Feletar, Stephen Hall, Paul Bird
The Journal of Rheumatology Jan 2016, 43 (1) 75-80; DOI: 10.3899/jrheum.150347
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Keywords

PSORIATIC ARTHRITIS
MAGNETIC RESONANCE IMAGING
PsAMRIS
DACTYLITIS

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Keywords

  • PSORIATIC ARTHRITIS
  • MAGNETIC RESONANCE IMAGING
  • PsAMRIS
  • DACTYLITIS

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