Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


REMISSIONPLUS: Multicenter Evaluation of Low-Field MRI for Monitoring Treatment Response in Rheumatoid Arthritis Patients.

Ostendorf8,  Ben, Kamp8,  Sabine, Koerbl2,  Birthe, Reichelt1,  Dorothea, Strassburger2,  Klaus, Scherer1,  Axel, Blaschke9,  Sabine

Department of Radiology, Heinrich-Heine-University Düsseldorf, Düsseldorf, NRW, Germany
Rheumatology, Kerckhoff Clinic, Bad Nauheim, Germany
Rheumatology, Martin Luther University, Halle-Wittenberg, Halle, Germany
German Diabetes Center at the Heinrich-Heine-University Düsseldorf, Leibniz Center for Diabetes Research, Institute of Biometrics and Epidemiology, Düsseldorf, NRW, Germany
Rheumatology Center, Hannover, Hannover, Germany
Rheumatology Clinic, Berlin-Buch, Berlin, Germany
Rheumatology Department, Heidelberg University Hospital, Heidelberg, Germany
Rheumatology Office, Bad Aibling, Bad Aibling, Germany
Rheumatology Office, Heidelberg, Heidelberg, Germany
Rheumatology, Department of Endocrinology, Diabetology and Rheumatology, Rhine-Ruhr Rheumatology Center, Heinrich-Heine-University Düsseldorf, Düsseldorf, NRW, Germany
Rheumatology, Göttingen University Hospital, Göttingen, Germany

Objective:

Multicenter evaluation of low-field MRI as a tool for monitoring treatment response in patients with rheumatoid arthritis (RA) on the REMISSION PLUS pilot project.

Methods:

RA patients initiating treatment with a DMARD or biologic at 9 sites throughout Germany underwent low-field MRI (C-scan, Esaote, 0.2 T) of the clinically dominant hand at time points T0 (baseline), T1 (3 months) and T2 (6 to 12 months). The images were evaluated semiquantitatively using the RAMRIS scoring system and correlated with clinical and lab chemistry markers.

Results:

206 RA patients (T0), 58 = m, 148 = f, age (years): (mean=55.87, min.19, max. 84), time since diagnosis: (median=20.32 months, min. 0.2 months, max. 45 years), DAS28 (mean = 4.83, 2.1 – 8), rheumatoid factor positive n = 118, CCP antibody positive n = 118, treatment naive: n = 64, switching treatments: n = 187; MRI follow-up at 3 months (T1) and at 6 to 12 months (T2); T0 and T2: n=96; T0, T1 and T2: n=55. RAMRIS (T0-T1-T2): 41.58-29.62-21.91; MCP: 13.31-8.76-6.38; wrist: 28.19-20.74-15.50; synovitis score (MCP): 5.11-3.06-1.60; wrist: 4.47-3.64-2.54; edema score (MCP): 2.85-1.74-0.91; wrist: 10.04-5.60-2.91; erosion score (MCP): 5.35-4.13-3.87; wrist: 13.68-11.49-10.06; SRM (standardized response mean (> 0.5 moderate potential to detect changes)) T0-T2 synovitis: 0.999 (MCP); 0.709 (wrist), edema: 0.702 (MCP); 0.792 (wrist); p-correlations T0-DAS28 for synovitis: 0.010 (MCP); 0.037 (wrist); for edema: 0.507 (MCP); 0.049 (wrist); T0-CRP for synovitis: 0.538 (MCP); 0.276 (wrist); for edema: 0.154 (MCP); 0.011 (wrist).

Conclusions:

Low-field MRI is a sensitive imaging method and RAMRIS a practicable scoring system for morphological and semiquantitative evaluation of therapeutic response to real-life rheumatologic care in significant correlation to clinical and lab data. The added benefit of low-field MRI is that it provides in-depth information on the severity of synovitis, edema (significant reduction on treatment) and erosion during follow-up, hence enabling early identification of responders/non-responders and providing a basis for individual prediction of prognosis and optimal disease management.

The project is supported by Abbott Immunology and Esaote Biomedica Deutschland GmbH.

To cite this abstract, please use the following information:
Ostendorf, Ben, Kamp, Sabine, Koerbl, Birthe, Reichelt, Dorothea, Strassburger, Klaus, Scherer, Axel, et al; REMISSIONPLUS: Multicenter Evaluation of Low-Field MRI for Monitoring Treatment Response in Rheumatoid Arthritis Patients. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :138
DOI: 10.1002/art.27907

Abstract Supplement

Meeting Menu

2010 ACR/ARHP