Production of IL17A in Synovial Tissue Correlates with MRI RAMRIS Scores in ACPA Positive Early Rheumatoid Arthritis

Thomas Kirchgesner¹, Christine Galant ², Bernard Lauwerys ³, Bruno Vande Berg ¹, Tatiana Sokolova ⁴, Laurent Meric de Bellefon ⁵, Adrien Nzeusseu ⁵ and Patrick Durez ⁶, ¹Musculoskeletal Imaging Unit, Cliniques universitaires Saint-Luc - Université Catholique de Louvain - Institut de Recherche Expérimentale et Clinique (IREC), Brussels, Belgium, Bruxelles, Belgium, ²Histopathology, Cliniques universitaires Saint-Luc - Université Catholique de Louvain - Institut de Recherche Expérimentale et Clinique (IREC), Brussels, Belgium, Bruxelles, Belgium, ³Rheumatology, Cliniques universitaires Saint-Luc - Université Catholique de Louvain - Institut de Recherche Expérimentale et Clinique (IREC), Brussels, Belgium, Brussels, Belgium, ⁴Rheumatology, Cliniques universitaires Saint-Luc - Université Catholique de Louvain - Institut de Recherche Expérimentale et Clinique (IREC), Brussels, Belgium, Bruxelles, Belgium, ⁵Cliniques universitaires Saint-Luc - Université Catholique de Louvain - Institut de Recherche Expérimentale et Clinique, Bruxelles, Belgium, ⁶Pôle de Recherche en Rhumatologie, Institut de Recherche Expérimentale et Clinique, UCL Saint-Luc, Brussels, Belgium

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: Early Rheumatoid Arthritis, OMERACT RAMRIS scores and IL17A, synovial biopsy

Session Information

Date: Sunday, November 10, 2019

Session Title: RA – Diagnosis, Manifestations, & Outcomes Poster I: Risk Factors, Predictors, & Prognosis

Session Type: Poster Session (Sunday)

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

Background/Purpose: We previously studied evolution of MRI RAMRIS scores in a group of 28 early rheumatoid (RA) patients treated with first-line infliximab (IFX) versus placebo. After 4 months, we observed a significant improvement of the scores in IFX-treated patients, while the changes in placebo-treated individuals were minimal. Here, we used synovial tissue samples obtained at baseline and 4 months after initiation of therapy, in order to study correlations between synovial IL17A and clinical/MRI scores of disease activity.

Methods: Twenty eight patients with treatment naive early ACPA positive RA were enrolled. Disease activity measures (DAS28-CRP) were evaluated at baseline, weeks 2 and 4, and every 4 weeks until week 52. OMERACT RAMRIS scores (and each of their components: erosion, osteitis, synovitis, tenosynovitis), synovial biopsy inflammation and quantitative evaluation of IL17A immunostained sections were evaluated at baseline and month 4.

Results: 28 pts were randomized (mean age: 48 +/- 12 yrs; mean duration of arthritis: 0.34 +/- 0.53 yr; mean CRP level: 1.67 +/- 2.23 mg/dL). A synovial biopsy was performed in 18 patients. A strong correlation was observed between IL17A expression and total RAMRIS score or any of its components (see table and graph). No association of IL17A expression was observed across the different pathotypes (pauci-immune vs myeloid-lymphoid).

Higher synovial IL17A was also associated with a better improvement of the RAMRIS score at month 4 in IFX-treated patients (0.2799 ± 0.2102 vs 0.0216 ± 0.0223, p=0.029).

No correlation was observed between synovial IL17A and disease activity measures.

Conclusion: In this small randomized cohort of ACPA positive early RA patients, we observed a good correlation between IL17A expression in the synovium and MRI RAMRIS score, underlining the potential role of the cytokine in disease severity and progression.

ACR19-UA RAMRIS_Graph

Figure: IL17A expression and baseline total RAMRIS score correlation

ACR19-UA RAMRIS_Table

Table: IL17A expression and RAMRIS scores correlations

Disclosure: T. Kirchgesner, None; C. Galant, None; B. Lauwerys, None; B. Vande Berg, None; T. Sokolova, None; L. Meric de Bellefon, None; A. Nzeusseu, None; P. Durez, BMS, 8, Bristol-Myers Squibb, 8, Celltrion, 8, Eli Lilly, 8, Hospira, 8, Mundipharma, 8, Pfizer, 8, Samsung, 8, Sanofi, 8, UCB, 8.

To cite this abstract in AMA style:

Kirchgesner T, Galant C, Lauwerys B, Vande Berg B, Sokolova T, Meric de Bellefon L, Nzeusseu A, Durez P. Production of IL17A in Synovial Tissue Correlates with MRI RAMRIS Scores in ACPA Positive Early Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/production-of-il17a-in-synovial-tissue-correlates-with-mri-ramris-scores-in-acpa-positive-early-rheumatoid-arthritis/. Accessed July 3, 2020.

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