RT Journal Article
SR Electronic
T1 Structural Changes over a Short Period Are Associated with Functional Assessments in Rheumatoid Arthritis
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 676
OP 684
DO 10.3899/jrheum.180496
VO 46
IS 7
A1 Tomohiro Shimizu
A1 Ana Cruz
A1 Matthew Tanaka
A1 Kenji Mamoto
A1 Valentina Pedoia
A1 Andrew J. Burghardt
A1 Ursula Heilmeier
A1 Thomas M. Link
A1 Jonathan Graf
A1 John B. Imboden
A1 Xiaojuan Li
YR 2019
UL http://www.jrheum.org/content/46/7/676.abstract
AB Objective. To investigate the correlation between changes in radiological quantitative assessment with changes in clinical and functional assessment from baseline to 3 months in patients with rheumatoid arthritis (RA).Methods. Twenty-eight patients with RA [methotrexate (MTX) and anti-tumor necrosis factor–α (TNF-α) group with high disease activity (n = 18); and MTX group with low disease activity (n = 10)] underwent assessments at baseline and 3 months: clinical [28-joint count Disease Activity Score (DAS28)], functional [Health Assessment Questionnaire (HAQ) and Michigan Hand Outcome Questionnaire (MHQ)], and imaging-based [3 Tesla magnetic resonance imaging (MRI) and high-resolution peripheral quantitative computed tomography (HR-pQCT)]. MR images were evaluated semiquantitatively [RA MRI scoring (RAMRIS)] and quantitatively for the volume of synovitis and bone marrow edema (BME) lesions. Erosion volumes were measured using HR-pQCT.Results. After 3 months, the anti-TNF-α group demonstrated an improvement in disease activity through DAS28, HAQ, and MHQ. MRI showed significant decreases in synovitis and BME volume for the anti-TNF-α group, and significant increases in the MTX group. HR-pQCT showed significant decreases in bone erosion volume for the anti-TNF-α group, and significant increases in the MTX group. No significance was observed using RAMRIS. Changes in synovitis, BME, and erosion volumes, but not RAMRIS, were significantly correlated with changes in DAS28, HAQ, and MHQ.Conclusion. Quantitative measures were more sensitive than semiquantitative grading when evaluating structural and inflammatory changes with treatment, and were associated with patient clinical and functional outcomes. Multimodality imaging with 3T MRI and HR-pQCT may provide promising biomarkers that help determine disease progression and therapy response.