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Abstract Number: 236

Are Magnetic Resonance Imaging Features of the Hand Associated with Patient Reported Physical Function, Global Assessment of Disease Activity, Pain and Health Related Quality of Life in Rheumatoid Arthritis in Clinical Remission? – Longitudinal Results from an Observational Cohort

Daniel Glinatsi1, Cecilie Heegaard Brahe2, Merete Lund Hetland1,3,4, Lykke Ørnbjerg1, Simon Krabbe5, Joshua Baker6, Mikael Boesen7, Zoreh Rastiemadabadi8, Lone Morsel-Carlsen8,9, Henrik Rogind1,3, Hanne Slott Jensen10, Annette Hansen11, Jesper Nørregaard12, Søren Jacobsen3,13, Lene Terslev1, Tuan Huynh12, Natalia Manilo14, Dorte Vendelbo Jensen1,15, Jakob M. Møller16, Niels Steen Krogh15 and Mikkel Østergaard1,3,17, 1Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Denmark, Copenhagen, Denmark, 2Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Denmark, Glostrup, Denmark, 3University of Copenhagen, Copenhagen, Denmark, 4The DANBIO Registry, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark, 5Center for Rheumatology and Spine Diseases, Copenhagen Center for Arthritis Research, Rigshospitalet, Copenhagen, Denmark, 6Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, 7Department of Radiology and the Parker institute, Copenhagen University Hospital Frederiksberg, Copenhagen, Denmark, 8Department of Radiology, Copenhagen University Hospital Frederiksberg, Copenhagen, Denmark, 9Department of Radiology, Rigshospitalet, Copenhagen, Denmark, 10Center for Rheumatology and Spine Diseases, Copenhagen University Hospital Frederiksberg, Denmark, Copenhagen, Denmark, 11Department of Rheumatology, Copenhagen University Hospital Gentofte, Copenhagen, Denmark, 12Center for Rheumatology and Spine Diseases, Nordsjællands Hospital, Hillerød, Denmark, 13Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark, 14Center for Rheumatology and Spine Diseases, Copenhagen University Hospital Frederiksberg, Copenhagen, Denmark, 15The DANBIO Registry, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark, 16Department of Radiology, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark, 17Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

Meeting: ACR/ARHP Annual Meeting 2017

Date of first publication: September 18, 2017

Keywords: , ,

Session Information

Date: Sunday, November 5, 2017

Title: Imaging of Rheumatic Diseases Poster I

Session Type: ACR Poster Session A

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

Background/Purpose: To assess whether magnetic resonance imaging (MRI) inflammation and damage in the wrist and hand of rheumatoid arthritis (RA) patients are associated with patient-reported outcomes (PROs) at clinical remission and relapse.

Methods: MRIs of the right wrist and hand were obtained in 114 patients with established RA in sustained clinical remission (>1 year), before tapering their biologic disease-modifying antirheumatic drug. MRIs were assessed according to the Outcome Measures in Rheumatology (OMERACT) RA MRI score (RAMRIS) for inflammation (synovitis/tenosynovitis/osteitis) and damage (bone erosions/joint space narrowing (JSN)) at baseline (i.e. remission, n=114) and in case of a relapse (n=70). Status and change MRI-scores were assessed for associations with patient-reported physical function (health assessment questionnaires (HAQ)), visual analogue scales for global disease activity and pain, EuroQol 5 dimensions and Short Form 36 physical and mental component summary (SF-36 PCS/MCS) using Spearman correlations, and in univariate/multivariable linear regression analyses including generalized estimating equations. C-reactive protein and swollen joint counts were forced into the models. MRI features were also assessed for trends against specific hand-related HAQ-items using Jonckheere trend tests.

Results: MRI-assessed bone erosion, JSN and combined damage score were associated with impaired PROs, mainly HAQ and SF-36 PCS at clinical remission and relapse (p<0.01), independent of clinical measures. The levels of bone erosions and JSN were associated with the level of the HAQ score in 4 of 5 hand-related HAQ-items (p<0.05). MRI-assessed inflammation was generally not associated with PROs at remission or relapse.

Conclusion: In patients with established RA MRI-assessed wrist and hand damage, but not inflammation is associated with patient-reported physical impairment at clinical remission and relapse, and the amount of damage in the wrist and hand is associated with reduced function of the hand.

HAQ

VAS-PtGlobal

VAS-Pain

Univariate

Multivariable

Univariate

Multivariable

Univariate

Multivariable

β (95% CI)

p

β (95% CI)

p

β (95% CI)

p

β (95% CI)

p

β (95% CI)

p

β (95% CI)

p

MRI Synovitis

0.00

(-0.03;0.03)

0.97

-0.39

(-1.63;0.84)

0.53

-0.31

(-1.37;0.76)

0.57

MRI Tenosynovitis

0.00

(-0.03;0.03)

0.77

0.58

(-0.95;2.10)

0.46

0.67

(-0.63;1.96)

0.31

MRI Osteitis

0.00

(-0.02;0.03)

0.86

0.51

(-0.36;1.38)

0.25

0.21

(-0.55;0.97)

0.59

MRI Bone Erosion

0.01 (0.00;0.01)

0.001

0.01

(0.00;0.01)

0.001**

0.04

(-0.08;0.15)

0.52

0.06

(-0.06;0.17)

0.34

MRI JSN

0.01

(0.00;0.02)

0.002

0.01

(0.00;0.02)

0.001**

0.09

(-0.14;0.33)

0.44

0.12

(-0.11;0.35)

0.32

MRI Combined Inflammation

0.00

(-0.01;0.02)

0.83

0.08

(-0.48;0.64)

0.77

-0.03

(-0.42;0.49)

0.89

MRI Combined Damage*

0.004

(0.000.01)

0.002

0.004

(0.00;0.01)

0.001

0.03

(-0.05;0.10)

0.49

0.04

(-0.04;0.11)

0.33

SF-36 PCS

SF-36 MCS

EQ-5D

Univariate

Multivariable

Univariate

Multivariable

Univariate

Multivariable

β (95% CI)

p

β (95% CI)

p

β (95% CI)

p

β (95% CI)

p

β (95% CI)

p

β (95% CI)

p

MRI Synovitis

-0.04

(-0.55;0.46)

0.88

0.14

(-0.32;0.60)

0.55

0.00

(-0.01;0.01)

0.88

MRI Tenosynovitis

-0.04

(-0.68;0.60)

0.91

0.18

(-0.34;0.69)

0.51

0.00

(-0.01;0.01)

0.78

MRI Osteitis

-0.08

(-0.46;0.30)

0.67

-0.05

(-0.52;0.42)

0.84

0.00

(-0.01;0.00)

0.43

MRI Bone Erosion

-0.07

(-0.12;-0.02)

0.004

-0.08

(-0.13;-0.03)

0.001**

0.01

(-0.05;0.07)

0.75

0.00

(0.00;0.00)

0.57

MRI JSN

-0.14

(-0.24;-0.05)

0.004

-0.16

(-0.27;-0.06)

0.002**

0.02

(-0.10;0.14)

0.78

0.00

(-0.00;0.00)

0.63

MRI Combined Inflammation

-0.02

(-0.25;0.21)

0.85

0.06

(-0.20;0.32)

0.63

0.00

(0.00;0.00)

0.75

MRI Combined Damage*

-0.05

(-0.08;-0.02)

0.003

-0.06

(-0.09;-0.02)

0.001

0.01

(-0.03;0.04)

0.76

0.00

(0.00;0.00)

0.59

Table 4. Univariate and multivariable general estimating equations (GEEs) for the association between MRI features and PROs. All analyses were adjusted for age and sex.

*If combined damage scores had a p-value ≤0.10 in univariate analyses, these were included in a separate multivariable model with CRP and SJC included in the model. **This parameter was included in a separate multivariable GEE model with SJC and CRP, due to co-linearity between bone erosion and JSN.

Abbreviations: HAQ: Health assessment questionnaire, VAS: Visual analogue scale, PtGlobal: Patient’s assessment of global disease activity, MRI: Magnetic resonance imaging, JSN: Joint space narrowing, SF-36: Short Form 36, PCS: Physical component summary, MCS: Mental component summary, EQ-5D: EuroQol 5 dimensions.
Disclosure: D. Glinatsi, None; C. H. Brahe, None; M. Lund Hetland, None; L. Ørnbjerg, None; S. Krabbe, None; J. Baker, None; M. Boesen, None; Z. Rastiemadabadi, None; L. Morsel-Carlsen, None; H. Rogind, None; H. S. Jensen, None; A. Hansen, Calgene, 5,Pfizer Inc, 5,Abvie, 6; J. Nørregaard, None; S. Jacobsen, None; L. Terslev, None; T. Huynh, None; N. Manilo, None; D. V. Jensen, None; J. M. Møller, None; N. S. Krogh, None; M. Østergaard, None.

To cite this abstract in AMA style:

Glinatsi D, Brahe CH, Lund Hetland M, Ørnbjerg L, Krabbe S, Baker J, Boesen M, Rastiemadabadi Z, Morsel-Carlsen L, Rogind H, Jensen HS, Hansen A, Nørregaard J, Jacobsen S, Terslev L, Huynh T, Manilo N, Jensen DV, Møller JM, Krogh NS, Østergaard M. Are Magnetic Resonance Imaging Features of the Hand Associated with Patient Reported Physical Function, Global Assessment of Disease Activity, Pain and Health Related Quality of Life in Rheumatoid Arthritis in Clinical Remission? – Longitudinal Results from an Observational Cohort [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/are-magnetic-resonance-imaging-features-of-the-hand-associated-with-patient-reported-physical-function-global-assessment-of-disease-activity-pain-and-health-related-quality-of-life-in-rheumatoid-art/. Accessed .

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