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Research ArticlePsoriatic Arthritis

Comparing Psoriatic Arthritis Low-field Magnetic Resonance Imaging, Ultrasound, and Clinical Outcomes: Data from the TICOPA Trial

Philip S. Helliwell, Laura C. Coates, Ne Siang Chew, Giovanni Lettieri, Anna R. Moverley, Jane E. Freeston, Jackie Nam, Robin Waxman, Paul Emery and Philip G. Conaghan
The Journal of Rheumatology September 2020, 47 (9) 1338-1343; DOI: https://doi.org/10.3899/jrheum.181385
Philip S. Helliwell
From the Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford; Bradford Teaching Hospitals Foundation Trust, Bradford; York Teaching Hospitals NHS Foundation Trust, Scarborough General Hospital, Department of Rheumatology, Scarborough, UK.
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  • For correspondence: p.helliwell@leeds.ac.uk
Laura C. Coates
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Ne Siang Chew
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Giovanni Lettieri
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Anna R. Moverley
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Jane E. Freeston
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Jackie Nam
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Robin Waxman
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Paul Emery
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Philip G. Conaghan
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Abstract

Objective. The Tight Control of inflammation in Psoriatic arthritis (TICOPA; isrctn.com: ISRCTN30147736) trial compared standard care (StdC) and tight control (TC) in early psoriatic arthritis (PsA), demonstrating better outcomes for TC. This substudy evaluated the performance metrics of modern imaging outcomes and compared them to the clinical data.

Methods. Non-contrast 0.2T magnetic resonance imaging (MRI; single hand) was assessed using the Outcomes in Rheumatology (OMERACT) PsA MRI Scoring System (PsAMRIS) with an additional global inflammation score. Ultrasound (US; same hand) was scored for greyscale, power Doppler, and erosions at the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints and scores summated.

Results. Seventy-eight patients had paired (baseline and 48 weeks) US data and 61 paired MRI data; 50 had matched clinical, MR, and US data. Significant within-group changes were seen for the inflammatory PsAMRIS components at MCP level: MRI global inflammation [median difference (range), standardized response mean (SRM)]: 3.25 (−5.0 to 12.0), 0.68; 1.0 (−4.5 to 17.5), 0.45 for TC and StdC, respectively. Similar within-group differences were obtained for US: 1.0 (−13.0 to 23.0), 0.45; 3.0 (−6.0 to 21.0), 0.77 for TC and StdC, respectively. No differences were seen between treatment groups. Significant correlations were found between baseline and change MRI and US scores. A significant correlation was found between baseline PsA disease activity scores and MRI global inflammation scores (Spearman ρ for MCP, PIP: 0.46, 0.63, respectively). No differences in erosion progression were observed.

Conclusion. The PsAMRIS and US inflammation scores demonstrated good responsiveness. No between-group differences were demonstrated, but this substudy was likely underpowered to determine differences between the 2 treatment strategies.

Key Indexing Terms:
  • PSORIATIC ARTHRITIS
  • MAGNETIC RESONANCE IMAGING
  • ULTRASOUND
  • JOINT INFLAMMATION
  • JOINT EROSIONS

Footnotes

  • The TICOPA study was supported by Arthritis Research UK (grant no 18825) and Pfizer. This study presents independent research supported by the NIHR Leeds Biomedical Research Centre (BRC). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health and Social Care.

  • Accepted for publication October 18, 2019.
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Comparing Psoriatic Arthritis Low-field Magnetic Resonance Imaging, Ultrasound, and Clinical Outcomes: Data from the TICOPA Trial
Philip S. Helliwell, Laura C. Coates, Ne Siang Chew, Giovanni Lettieri, Anna R. Moverley, Jane E. Freeston, Jackie Nam, Robin Waxman, Paul Emery, Philip G. Conaghan
The Journal of Rheumatology Sep 2020, 47 (9) 1338-1343; DOI: 10.3899/jrheum.181385

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Comparing Psoriatic Arthritis Low-field Magnetic Resonance Imaging, Ultrasound, and Clinical Outcomes: Data from the TICOPA Trial
Philip S. Helliwell, Laura C. Coates, Ne Siang Chew, Giovanni Lettieri, Anna R. Moverley, Jane E. Freeston, Jackie Nam, Robin Waxman, Paul Emery, Philip G. Conaghan
The Journal of Rheumatology Sep 2020, 47 (9) 1338-1343; DOI: 10.3899/jrheum.181385
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Keywords

PSORIATIC ARTHRITIS
MAGNETIC RESONANCE IMAGING
ULTRASOUND
JOINT INFLAMMATION
JOINT EROSIONS

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Keywords

  • psoriatic arthritis
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  • JOINT INFLAMMATION
  • JOINT EROSIONS

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