Hip Inflammation MRI Scoring System (HIMRISS) to Predict Response to Hyaluronic Acid (HAnox-M-XL) Injection in Hip Osteoarthritis

Nicolas Deseyne¹, Damien Loeuille², Thierry Conrozier³, Ulrich Weber⁴, Jacob Jaremko⁵, Henri Lellouche⁶, Bernard Maillet⁷, Joel Paschke⁸, Jonathan Epstein⁹ and Walter P. Maksymowych¹⁰, ¹Department of Rheumatology, CHRU Vandoeuvre les Nancy,, Vandoeuvre, France, ²Rheumatology, CHRU Nancy, Vandoeuvre les Nancy, France, ³Department of Rheumatology, North Hospital Franche-Comté, Belfort, France, ⁴Department of Research, King Christian 10th Hospital for Rheumatic Diseases, Graasten, Denmark, ⁵Radiology, Radiology, University of Alberta, Edmonton, AB, Canada, ⁶Department of Rheumatology, Lariboisière Hospital, Paris, France, Paris, France, ⁷Department of Rheumatology, Clinique Saint Odilon, Moulins, France, Moulins, France, ⁸CaRE Arthritis, Edmonton, AB, Canada, ⁹CEC-Inserm CIE6, Epidemiology and Clinical Evaluations Department, CHRU Vandoeuvre les Nancy, France, Vandoeuvre Les Nancy, France, ¹⁰Medicine, University of Alberta, Edmonton, AB, Canada

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: bone marrow lesions, Hip, hyaluronate and osteoarthritis, MRI

Session Information

Date: Sunday, November 13, 2016

Title: Osteoarthritis – Clinical Aspects - Poster I

Session Type: ACR Poster Session A

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

Background/Purpose: To assess predictors of response, according to hip MRI inflammatory scoring system (HIMRISS), in a sample of patients with hip osteoarthritis (OA) treated by hyaluronic acid (HA) injection (HAnox-M-XL).

Methods: 60 patients with hip OA were included. Clinical outcomes were assessed at baseline and three months after HAnox-M-XL injection by WOMAC50 scoring. On hip MRI performed just before HA injection, bone marrow lesion (BML) and synovitis were assessed by HIMRISS by four readers. The inter-reader reliability of HIMRISS, and associations between MRI features and clinical data were assessed. Logistic regression (univariate and multivariate) was used to explore associations between MRI features and response to HA injection, according to WOMAC50 response at three months.

Results: Inter-reader intra-class correlation coefficients for HIMRISS varied from 0.64 [0.52-0.74] for acetabular bone marrow lesion (BML), to 0.86 [0.81-0.89] for HIMRISS total. 45.5% of patients met WOMAC50 response. At baseline, WOMAC-function correlated significantly to HIMRISS synovitis-effusion (r=0.27, p=0.03). In univariate analysis, BML femoral according to binary assessment (p=0.025), HIMRISS BML femoral (p=0.0038), HIMRISS BML acetabular (p=0.042) and HIMRISS total (p=0.0092) were associated negatively with WOMAC50 response. In multivariate analysis, adjusted for age and BMI, HIMRISS femoral BML (p=0.02) and HIMRISS total (p=0.016) were negatively associated with response. At a HIMRISS threshold of <15, 82% of patients were responders, with specificity SP=0.97, sensitivity SN=0.39, and positive and negative predictive values of 0.91 and 0.64 respectively.

Conclusion: HIMRISS is reliable for total scores and sub-domains (acetabular and femoral BML, and synovitis-effusion). It permits identification of responders to HAnox-M-XL injection in hip OA patients.

Disclosure: N. Deseyne, None; D. Loeuille, None; T. Conrozier, None; U. Weber, None; J. Jaremko, None; H. Lellouche, None; B. Maillet, None; J. Paschke, None; J. Epstein, None; W. P. Maksymowych, None.

To cite this abstract in AMA style:

Deseyne N, Loeuille D, Conrozier T, Weber U, Jaremko J, Lellouche H, Maillet B, Paschke J, Epstein J, Maksymowych WP. Hip Inflammation MRI Scoring System (HIMRISS) to Predict Response to Hyaluronic Acid (HAnox-M-XL) Injection in Hip Osteoarthritis [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/hip-inflammation-mri-scoring-system-himriss-to-predict-response-to-hyaluronic-acid-hanox-m-xl-injection-in-hip-osteoarthritis/. Accessed .

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