Background/Purpose:

To ascertain the predictors of erosion progression in patients with early RA using high-resolution peripheral quantitative computed tomography (HR-pQCT).

Methods:

In this prospective study, 80 ERA patients were treated with a tight-control protocol aiming at remission using csDMARDs. HR-pQCT examinations were performed at baseline and after one year post-baseline. Erosion number and volume and the bone density of the surrounding bone were quantified. Erosion progression was defined as an erosion showing both (a) an increase in erosion volume exceeding the smallest detectable change (SDC) and (b) a decrease in bone density surrounding the erosion exceeding the SDC.

Results:

45% ERA patients showed erosion progression. Logistic regression analysis showed that greater erosion depth (p=0.043) and higher damage joint count (p=0.035) at baseline were independent predictors of erosion progression at 12 months. Erosion depth discriminated ERA patients with erosion progression from those without progression with an area under receiver operating characteristic curve of 0.798 (95% CI: [0.650, 0.946]; p =0.002). An erosion depth at baseline of ≥1.225 mm predicted erosion progression with a sensitivity of 81.3%, specificity of 71.4% and a Youden index of 0.527.

Conclusion:

Erosion depth at baseline is an indicator of erosion progression in ERA patients treated with csDMARDs. Deeper erosions are more likely to progress than shallower erosions.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/erosion-depth-predicts-erosion-progression-in-patients-with-early-ra-a-longitudinal-analysis-using-hr-pqct/