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:
We used data from a large clinical trial of golimumab
(GO-BEFORE) to comprehensively assess associations between magnetic resonance
imaging (MRI) measures of synovitis, osteitis, and bone erosion with patient-reported measures
of physical functioning, pain, and global disease activity in rheumatoid
arthritis (RA).
Methods: MRI of the dominant hand was performed and RAMRIS scores were
determined at baseline, and at weeks 12, 24, 52. van
der Heijde– Sharp scores (vdHS)
were determined from radiography at baseline and 52 weeks. Standard
patient-reported measures were recorded at these time-points including the
Health Assessment Questionnaire (HAQ), as well as pain and patient global
scores as measured by visual analogue scale. Spearman correlations as well as
multivariable linear and logistic regression utilizing robust generalized
estimating equations (GEE) were used to assess relationships between RAMRIS
measures and patient-reported outcomes over all time-points.
Results:
Correlations between all MRI measures and HAQ were noted at all time-points
(Table 1). Pain and patient global scores were increasingly correlated at
later follow-up times. In multivariate models incorporating all time-points, synovitis and bone erosion were associated with HAQ
independent of clinical disease activity as measured by the DAS28. Greater synovitis was also associated with greater pain and greater
patient global scores independent of C-Reactive Protein (CRP) and
swollen/tender joint counts. Greater improvements in synovitis
were correlated with improvements in HAQ at all time-points and associated with
improvements in pain at early time-points (Table 2). Considering all intervals
over which change could occur, changes in synovitis
were associated with changes in HAQ (p=0.001), pain (p=0.02), and patient
global scores (p=0.02). After adjusting for baseline HAQ, and baseline and
52-week change in synovitis, increases in erosion at
52 weeks (per unit) were associated with increases in HAQ (β: 0.038, p=0.01), pain (β: 0.18, p=0.006), and patient global scores (β: 0.17, p=0.005). In contrast increases in vdHS were not associated in similar models (all p>0.7).
Conclusion:
Synovitis was associated with physical functioning,
pain, and patient global scores, independently of measures of clinical disease
activity. Improvements in synovitis correlated with
improvements patient-reported outcomes, while increases in MRI erosion were
associated with worsening. Changes in MRI findings are likely to have important
implications for how patients experience their disease.
|
Table 1: Spearman correlations at 0, 12, 24, and 52 weeks between synovitis, bone edema, bone erosion, and HAQ, pain, and patient global. |
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HAQ
|
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|
Week 0 |
Week 12 |
Week 24 |
Week 52 |
|
|
Synovitis |
0.24 *** |
0.20 *** |
0.26 *** |
0.27 *** |
|
|
Bone Edema |
0.13 ** |
0.19 ** |
0.23 *** |
0.22 *** |
|
|
Bone Erosion |
0.18 ** |
0.23 *** |
0.27 *** |
0.28 *** |
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|
Pain
|
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|
Week 0 |
Week 12 |
Week 24 |
Week 52 |
|
|
Synovitis |
0.093 |
0.13 * |
0.17 ** |
0.21 ** |
|
|
Bone Edema |
0.0073 |
0.14 * |
0.14 * |
0.21 ** |
|
|
Bone Erosion |
0.072 |
0.12 * |
0.14 * |
0.20 ** |
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|
Patient Global
|
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|
Week 0 |
Week 12 |
Week 24 |
Week 52 |
|
|
Synovitis |
0.14 * |
0.16 ** |
0.18 ** |
0.24 *** |
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|
Bone Edema |
0.046 |
0.16 ** |
0.14 * |
0.23 *** |
|
|
Bone Erosion |
0.11 |
0.15 * |
0.15 * |
0.21 ** |
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|
* p<0.05; ** p<0.01; *** p<0.001 |
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Table 2: Spearman correlations of change in synovitis, bone edema, and bone erosion with change in HAQ, pain, and patient global scores over same time-period. |
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|
HAQ |
Pain |
Patient Global |
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|
Synovitis |
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Week 12 |
0.19 ** |
0.17 * |
0.13 |
|
|
Week 24 |
0.17 ** |
0.17 * |
0.10 |
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|
Week 52 |
0.24 *** |
0.14 |
0.16 * |
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|
Osteitis |
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Week 12 |
0.030 |
0.081 |
0.075 |
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|
Week 24 |
0.11 |
0.080 |
0.11 |
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|
Week 52 |
0.090 |
0.074 |
0.076 |
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|
Bone Erosion |
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Week 12 |
0.067 |
0.058 |
0.10 |
|
|
Week 24 |
0.10 |
0.15 * |
0.20 ** |
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|
Week 52 |
0.13 |
0.17 * |
0.17 * |
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* p<0.05; ** p<0.01; *** p<0.001 |
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To cite this abstract in AMA style:
Baker J, Conaghan PG, Baker D, Emery P, Østergaard M. MRI Measures of Disease Activity and Joint Damage Are Associated with Patient-Reported Outcomes in Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/mri-measures-of-disease-activity-and-joint-damage-are-associated-with-patient-reported-outcomes-in-rheumatoid-arthritis/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/mri-measures-of-disease-activity-and-joint-damage-are-associated-with-patient-reported-outcomes-in-rheumatoid-arthritis/