MRI Bone Oedema at Enrollment Predicts the Development of Rapid Radiographic Progression at 1 Year Toward Patients with Early-Stage Rheumatoid Arthritis: Results from Nagasaki University Early Arthritis Cohort

Yoshikazu Nakashima¹, Mami Tamai², Toru Michitsuji³, Toshimasa Shimizu², Shoichi Fukui⁴, Masataka Umeda¹, Ayako Nishino¹, Tomohiro Koga³, Shin-ya Kawashiri⁵, Naoki Iwamoto², Kunihiro Ichinose², Yasuko Hirai⁴, Hideki Nakamura⁴, Tomoki Origuchi⁶ and Atsushi Kawakami⁴, ¹Department of Immunology and Rheumatology, Nagasaki University, Nagasaki, Japan, ²Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan, ³Department of Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan, ⁴Nagasaki University, Nagasaki, Japan, ⁵Kyushu multicenter rheumatoid arthritis ultrasound prospective observational cohort study group, Nagasaki, Japan, ⁶Department of Rehabilitation Sciences, Nagasaki University, Nagasaki, Japan

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Early Rheumatoid Arthritis, MRI, Osteitis, radiography and synovitis

Session Information

Date: Sunday, November 8, 2015

Title: Rheumatoid Arthritis - Clinical Aspects Poster I

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: To clarify whether MRI bone oedema predicts the development of rapid radiographic progression (RRP) in Nagasaki University Early Arthritis Cohort patients with early-stage rheumatoid arthritis (RA).

Methods: Early-stage RA patients (n=76) were enrolled and underwent Gd-enhanced MRI of both wrists and finger joints. Synovitis, bone oedema and bone erosion were evaluated using the Rheumatoid Arthritis Magnetic Resonance Imaging score (RAMRIS). RRP was defined as an annual increment > 3 at 1 year by plain radiographs and the Genant-modified Sharp score. A multivariate logistic regression analysis was performed to establish the risk factors for RRP, using patients’ characteristics, serum variables, MRI findings, therapeutic responses and regime.

Results: The patients’ median age was 54.5 yrs, and their median disease duration at enrollment was 3 months. RRP was found in 12 of the 76 patients at 1 year. A univariate analysis revealed that matrix metalloproteinase-3, RAMRIS bone oedema score and RAMRIS bone erosion score were associated with RRP. Multivariate logistic regression analyses demonstrated that the RAMRIS bone oedema score at enrollment (5-point increase, OR 2.18, 95%CI 1.32–3.59, p=0.002) is the only independent predictor of the development of RRP at 1 year. An ROC analysis identified the best cut-off value for RAMRIS bone oedema score as 5.

Conclusion: Our findings suggest that MRI bone oedema is closely associated with the development of RRP in early-stage RA patients. Physicians should carefully control the disease activity when MRI bone oedema is observed in early RA patients.

Disclosure: Y. Nakashima, None; M. Tamai, None; T. Michitsuji, None; T. Shimizu, None; S. Fukui, None; M. Umeda, None; A. Nishino, None; T. Koga, None; S. Y. Kawashiri, None; N. Iwamoto, None; K. Ichinose, None; Y. Hirai, None; H. Nakamura, None; T. Origuchi, None; A. Kawakami, None.

To cite this abstract in AMA style:

Nakashima Y, Tamai M, Michitsuji T, Shimizu T, Fukui S, Umeda M, Nishino A, Koga T, Kawashiri SY, Iwamoto N, Ichinose K, Hirai Y, Nakamura H, Origuchi T, Kawakami A. MRI Bone Oedema at Enrollment Predicts the Development of Rapid Radiographic Progression at 1 Year Toward Patients with Early-Stage Rheumatoid Arthritis: Results from Nagasaki University Early Arthritis Cohort [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/mri-bone-oedema-at-enrollment-predicts-the-development-of-rapid-radiographic-progression-at-1-year-toward-patients-with-early-stage-rheumatoid-arthritis-results-from-nagasaki-university-early-arthrit/. Accessed .

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