Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose:
Prognosis of the patients with rheumatoid arthritis (RA) nowadays is supposed to become better by treat-to-target (T2T) strategy. Osteitis determined by magnetic resonance imaging (MRI) is known as a predictor toward radiographic progression. We have tried to examine in the present study whether the change of therapeutic strategy affect the clinical, radiographic and MRI outcome of early-stage RA patients of Japanese population.
Methods:
All of early-stage RA patients in the present study were recruited from Nagasaki University Early Arthritis Cohort in which the subjects received Gd-enhanced MRI of both wrist and finger joints. We have divided the periods of the Cohort into two parts. The first half includes the RA patients DMARDs treatment initiated from 2003 to 2007 (Group I: traditional therapy phase) whereas the second half includes those DMARDs treatment initiated from 2008 to 2011 (Group II: T2T phase). All of patients gave their informed consent to be subjected to the protocol that was approved by the Institutional Review Board of Nagasaki University. The good outcomes at 1 year after initiation of therapy were set as SDAI remission for clinical outcome, no radiographic progression by Genant modified Sharp score for radiographic outcome and improvement of RAMRIS osteitis score over 67% decrease or no appearance of RAMRIS osteitis for MRI outcome, respectively. We have tried to examine whether therapeutic strategies affect the outcome at 1 year in early-stage RA patients.
Results:
Ninety-two patients were included. Median disease duration at entry was 3 months and there were no significant differences of patients’ background between the 2 treatment groups. In T2T phase, the frequencies of MTX initiation, introduction of MTX within 1 year and the use of biologics within 1 year were significantly high as compared with traditional therapy phase. Regarding to the efficacy, the rate of SDAI remission, radiographic no progression and good outcome of MRI were significantly high at 1 year in T2T phase as compared with traditional therapy phase. Multivariate logistic regression analyses have identified; SDAI remission at 1 year is associated with T2T phase and no radiographic progression. No radiographic progression at 1 year is associated with SDAI remission and good outcome of MRI. Good outcome of MRI is associated with T2T phase and no radiographic progression. Good clinical, radiographic and MRI outcome associated each other.
Conclusion:
Present data suggest that stringent therapies in early-stage RA patients improve clinical, radiographic and MRI outcome, indicating an importance of T2T in daily clinical practice.
Disclosure:
M. Tamai,
None;
Y. Nakashima,
None;
J. Kita,
None;
A. Takatani,
None;
A. Nishino,
None;
T. Suzuki,
None;
Y. Horai,
None;
A. Okada,
None;
S. Y. Kawashiri,
None;
N. Iwamoto,
None;
K. Ichinose,
None;
K. Arima,
None;
H. Nakamura,
None;
T. Origuchi,
None;
M. Uetani,
None;
K. Eguchi,
UCB Pharma,
5;
A. Kawakami,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/stringent-therapies-improve-clinical-radiographic-and-magnetic-resonance-imaging-outcome-in-early-stage-rheumatoid-arthritis-patients-from-japanese-population-longitudinal-study-from-nagasaki-early/