TY - JOUR T1 - Determining a Magnetic Resonance Imaging Inflammatory Activity Acceptable State Without Subsequent Radiographic Progression in Rheumatoid Arthritis: Results from a Followup MRI Study of 254 Patients in Clinical Remission or Low Disease Activity JF - The Journal of Rheumatology JO - J Rheumatol SP - 398 LP - 406 DO - 10.3899/jrheum.131088 VL - 41 IS - 2 AU - Frédérique Gandjbakhch AU - Espen A. Haavardsholm AU - Philip G. Conaghan AU - Bo Ejbjerg AU - Violaine Foltz AU - Andrew K. Brown AU - Uffe Møller Døhn AU - Marissa Lassere AU - Jane E. Freeston AU - Inge Christoffer Olsen AU - Pernille Bøyesen AU - Paul Bird AU - Bruno Fautrel AU - Merete Lund Hetland AU - Paul Emery AU - Pierre Bourgeois AU - Kim Hørslev-Petersen AU - Tore K. Kvien AU - Fiona M. McQueen AU - Mikkel Østergaard Y1 - 2014/02/01 UR - http://www.jrheum.org/content/41/2/398.abstract N2 - Objective. To assess the predictive value of magnetic resonance imaging (MRI)-detected subclinical inflammation for subsequent radiographic progression in a longitudinal study of patients with rheumatoid arthritis (RA) in clinical remission or low disease activity (LDA), and to determine cutoffs for an MRI inflammatory activity acceptable state in RA in which radiographic progression rarely occurs. Methods. Patients with RA in clinical remission [28-joint Disease Activity Score-C-reactive protein (DAS28-CRP) < 2.6, n = 185] or LDA state (2.6 ≤ DAS28-CRP < 3.2, n = 69) with longitudinal MRI and radiographic data were included from 5 cohorts (4 international centers). MRI were assessed according to the Outcome Measures in Rheumatology (OMERACT) RA MRI scoring system (RAMRIS). Statistical analyses included an underlying conditional logistic regression model stratified per cohort, with radiographic progression as dependent variable. Results. A total of 254 patients were included in the multivariate analyses. At baseline, synovitis was observed in 95% and osteitis in 49% of patients. Radiographic progression was observed in 60 patients (24%). RAMRIS synovitis was the only independent predictive factor in multivariate analysis. ROC analysis identified a cutoff value for baseline RAMRIS synovitis score of 5 (maximum possible score 21). Rheumatoid factor (RF) status yielded a significant interaction with synovitis (p value = 0.044). RF-positive patients with a RAMRIS synovitis score of > 5 vs ≤ 5, had an OR of 4.4 (95% CI 1.72–11.4) for radiographic progression. Conclusion. High MRI synovitis score predicts radiographic progression in patients in clinical remission/LDA. A cutoff point for determining an MRI inflammatory activity acceptable state based on the RAMRIS synovitis score was established. Incorporating MRI in future remission criteria should be considered. ER -