Baseline MRI bone erosion predicts the subsequent radiographic progression in early rheumatoid arthritis patients who achieved sustained good clinical response
Baseline MRI bone erosion predicts the subsequent radiographic progression in early rheumatoid arthritis patients who achieved sustained good clinical response
复制标题
DOI：
10.1080/14397595.2017.1294280
复制
发表时间：
2017-01-01
影响因子：
2.2
通讯作者：
Kawakami, Atsushi
中科院分区：
文献类型：
--
作者：
Tamai, Mami;Arima, Kazuhiko;Kawakami, Atsushi
目的：探讨基线时磁共振成像（MRI）表现能否预测早期类风湿关节炎（RA）患者的影像学进展，这些患者已获得持续良好的临床反应。方法：这是一项来自长崎大学早期关节炎队列为期一年的观察性研究的亚分析。“良好临床反应”的定义是疾病活动性评分（DAS）在3个月时下降281.2，并在6-12个月内达到DAS28缓解。在基线时检查手腕和手指关节的gd增强MRI，并使用类风湿关节炎磁共振成像评分（RAMRIS）进行评分。Genant-modified Sharp评分(GSS)>的年增量定义为影像学进展。通过logistic回归分析确定影像学进展的预测因素。结果：本研究共选取24名受试者。基线时RAMRIS滑膜炎、骨水肿、骨侵蚀和GSS的中位值分别为6.5、0.5、0和0。5例患者在一年内出现影像学进展。多因素logistic回归分析显示，基线时RAMRIS骨侵蚀是一年后影像学进展的唯一独立预测因子（p= 0.032）。结论：我们的数据表明，MRI骨侵蚀预测早期RA的不良影像学结果，即使它已经成功治疗。
Objective: To examine whether magnetic resonance imaging (MRI) findings at baseline predict radiographic progression in early-stage rheumatoid arthritis (RA) patients who have achieved sustained good clinical response.Methods: This is a sub-analysis from the one-year observational study of Nagasaki University Early Arthritis Cohort. Definition of good clinical response' was a decrement of disease activity score (DAS) 281.2 at three months with achievement of DAS28 remission through 6-12 months. Gd-enhanced MRI of both wrists and finger joints were examined at baseline and scored using rheumatoid arthritis magnetic resonance imaging score (RAMRIS). Annual increment of Genant-modified Sharp score (GSS)>0 was defined as radiographic progression'. Predictors of radiographic progression were determined by logistic regression analysis.Results: Twenty-four subjects were selected in the present study. Each median RAMRIS synovitis, bone edema, bone erosion, and GSS at baseline were 6.5, 0.5, 0, and 0, respectively. Five patients developed radiographic progression at one year. Multivariate logistic regression analysis has shown that RAMRIS bone erosion at baseline is the only independent predictor of radiographic progression at one year (p=.032).Conclusions: Our data suggest that MRI bone erosion predicts poor radiographic outcome of early-stage RA even if it has been successfully treated.