Session Information
Date: Monday, November 9, 2015
Title: Imaging of Rheumatic Diseases Poster II: X-ray, MRI, PET and CT
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose:
Previous radiographic and MRI studies have demonstrated that abatacept (ABT) can inhibit the progression of bone and joint destruction in patients with rheumatoid arthritis (RA), just like other biologic agents. However, the relations between MRI scores and other disease indexes are not well-known. And MRI scans of only single hand have been performed in previous reports. The aim of the present study is to evaluate efficacy of ABT in patients with RA using MRI of bilateral hands and to investigate whether MRI scores are related to SDAI and HAQ scores in comparison with radiographic scores.
Methods:
Thirty-five RA patients who had not been received more than 1 biological agent were included in this study. MRI of bilateral hands was performed at baseline and 12 months of intravenous ABT treatment. MRI images were scored for synovitis (0-42), osteitis (0-138) and bone erosion (0-460) according to the Rheumatoid Arthritis MRI Scoring System. Conventional radiographs of hands and feet were also obtained at baseline and 12 months, and they were scored according to the van der Heijde modified total Sharp scoring system. These scores were read by two independent doctors, who were blinded to clinical data. Clinical assessment was performed at baseline and at 1, 3, 6, 9, 12 months. The primary endpoint was change from baseline in MRI-measured synovitis score (SS), osteitis score (OS) and bone erosion score (ES).
Results:
Thirty-one patients completed this study for 12 months. The mean SS and OS were significantly reduced at 12 months compared with the baseline (SS at baseline/ 12 months: 17.1±7.02/ 11.4±6.24 (p<0.0001), OS: 5.11±8.16/ 1.89±2.47 (p=0.003)). On the other hand, ES showed no change throughout the study (28.2±38.6/ 28.7±39.2 (p=0.380)). At 12 months, 57.1% of patients showed no progression in ES (deltaES≤0) and 63.6% of patients showed no progression in radiographic erosion score. Changes from baseline in SS (deltaSS) and ES (deltaES) were correlated with relative SDAI response (p=0.023/0.021), while radiographic scores were not correlated with SDAI score. SS, OS and ES at 12 months were correlated with HAQ score at 12 months (p=0.038/0.007/0.038), while radiographic scores were not correlated with HAQ score statistically. Patients achieving SDAI remission at 12 months (n=11) showed lower OS at 12 months (p=0.030) and lower deltaES (p=0.004) compared to those who didn’t achieve SDAI remission (n=20), while radiographic scores didn’t show significant differences between two groups. Patients achieving HAQ remission at 12 months (n=17) showed lower OS at 12 months (p=0.015), lower SS at 12 months (p=0.049), lower ES at 12 months (p=0.019) and lower deltaES (p<0.001) compared to those who didn’t achieve HAQ remission (n=13).
Conclusion:
ABT reduced synovitis and osteitis score in MRI of bilateral hands at 12 months. Compared to radiographs, MRI of bilateral hands showed higher correlations with SDAI and HAQ scores.
To cite this abstract in AMA style:
Kukida Y, Kasahara A, Seno T, Isoda Y, Sagawa T, Inoue T, Kamio N, Sagawa R, Kida T, Nakabayashi A, Nagahara H, Murakami K, Yamamoto A, Morita S, Ito H, Kohno M, Kawahito Y. Efficacy of Abatacept in Patients with Rheumatoid Arthritis Assessed By MRI Scans of Bilateral Hands [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/efficacy-of-abatacept-in-patients-with-rheumatoid-arthritis-assessed-by-mri-scans-of-bilateral-hands/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/efficacy-of-abatacept-in-patients-with-rheumatoid-arthritis-assessed-by-mri-scans-of-bilateral-hands/