Fluorescence Optical Imaging Xiralite® Is Helpful in the Decision for Rituximab Re-Therapy in Patients with Rheumatoid Arthritis

Sarah Ohrndorf¹, Lisa Ridha², Anne-Marie Glimm³, Gerd R. Burmester¹, Gabriela Schmittat³, Marina Backhaus⁴ and Jens Klotsche⁵, ¹Rheumatology and Clinical Immunology, Charité-University Medicine Berlin, Berlin, Germany, ²Department of Rheumatology and Clinical Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany, ³Department of Rheumatology and Clinical Immunology, Charité University Medicine Berlin, Berlin, Germany, ⁴Department of Rheumatology & Immunology, University Medicine Charit, Berlin, Germany, ⁵Program Area Epidemiology, German Rheumatism Research Center, Berlin, Germany

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Disease Activity, Rheumatoid arthritis (RA), rituximab and ultrasound

Session Information

Date: Tuesday, October 23, 2018

Title: Imaging of Rheumatic Diseases Poster III: Other Modalities

Session Type: ACR Poster Session C

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

Background/Purpose: Rituximab (RTX) is an effective and well-tolerated therapeutic option in rheumatoid arthritis (RA) patients with insufficient response to TNFα inhibitors. However, the exact time point of RTX re-therapy often varies and objective parameters (e.g. imaging, such as MRI and/or musculoskeletal ultrasound [US]) are not yet included in the RA treatment strategy [PMID: 28264816]. The aim of this study was to evaluate the ability of the fluorescence optical imaging Xiralite® (FOI) to predict RTX re-therapy in RA patients – in comparison to clinical, laboratory and US.

Methods: In this study, n=31 patients with established RA were included and prospectively followed over one year by DAS28, patient’s global VAS (0-100 mm), CRP/ESR, US7 score (for synovitis and tenosynovitis in greyscale and power Doppler of the clinically dominant hand/foot; [PMID: 19714611]), and by FOI (phases 1-3 and PrimaVistaMode [PVM]) at baseline (before RTX), and after 3,6, and 12 months. The need for RTX re-therapy was defined according to DAS28 response criteria by EULAR.

Results: Of the included 31 patients (female 77.4%, mean age 60.1±11.4, mean disease duration 14.9±7.1 years), n=14 (45.2%) received RTX re-therapy within 12 months: n=3 after 6months (mths), n=4 after 7mths, n=5 after 9mths, and n=2 after 10mths. In the group with RTX re-therapy, FOI in PVM mode was the only parameter that presented significant increase (beta 0.40, CI 0.08-0.71; p=0.013) – compared to the group without re-therapy. In the prediction model via receiver operating characteristic (ROC) analysis, FOI in PVM reached the highest values of all imaging parameters (phases 1-3, US) at baseline for the prediction of re-therapy over one year with an area under the curve (AUC) of 0.64 (OR 0.9, CI 0.79-1.03), however, without significance (p=0.117). Patient’s VAS and CRP had similar predictive power with AUC of 0.66 each (each p=ns).

Conclusion: The FOI Xiralite® in PVM is able to discriminate between groups with and without need for RTX re-therapy better than other included imaging parameters. It is able to predict the need for RTX re-therapy with comparable predictive power to patient’s VAS and CRP.

Disclosure: S. Ohrndorf, None; L. Ridha, None; A. M. Glimm, None; G. R. Burmester, None; G. Schmittat, None; M. Backhaus, None; J. Klotsche, None.

To cite this abstract in AMA style:

Ohrndorf S, Ridha L, Glimm AM, Burmester GR, Schmittat G, Backhaus M, Klotsche J. Fluorescence Optical Imaging Xiralite® Is Helpful in the Decision for Rituximab Re-Therapy in Patients with Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/fluorescence-optical-imaging-xiralite-is-helpful-in-the-decision-for-rituximab-re-therapy-in-patients-with-rheumatoid-arthritis/. Accessed .

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