Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
ID | PMID | Title | PublicationDate | abstract |
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23139011 | Fall incidence and outcomes of falls in a prospective study of adults with rheumatoid arth | 2013 May | OBJECTIVE: To determine the incidence of falls and to investigate the consequences of falls in adults with rheumatoid arthritis (RA). METHODS: A total of 559 community-dwelling adults with RA, ages 18-88 years (mean age 62 years, 69% women), participated in this prospective cohort study. After a detailed clinical assessment, patients were followed for 1 year, using monthly falls calendars and followup telephone calls. Followup took place in the participant's usual place of residence in the Northwest of England. Outcome measures included fall occurrence, reason for fall, type and severity of injuries, fractures, fall location, lie-times, use of health services, and functional ability. RESULTS: A total of 535 participants followed for 1 year had a total of 598 falls. Of these participants, 36.4% (95% confidence interval 32%-41%) reported falling during the 1-year followup period, with an incidence rate of 1,313 per 1,000 person-years at risk or 1.11 falls per person. Age and sex were not associated with falls. More than one-third of the falls were reportedly caused by hips, knees, or ankle joints "giving way." More than half of all the falls resulted in moderate injuries, including head injuries (n = 27) and fractures (n = 26). Treatment by general practitioners or other health professionals was required for 15.0% of falls, and emergency services were required for 8.8% of falls. CONCLUSION: These results indicate that adults with RA are at high risk of falls and fall-related injuries, fractures, and head injuries. Strategies to prevent falls in adults with RA must be prioritized to reduce falls, fall-related injuries, and fractures. | |
24794492 | Association of the MTHFR C677T and A1298C polymorphisms with methotrexate toxicity in rheu | 2014 Dec | The aim of this study was to explore whether the C677T and A1298C polymorphisms of methylenetetrahydrofolate reductase (MTHFR) play a role in methotrexate (MTX) toxicity in rheumatoid arthritis (RA). MEDLINE and EMBASE database searches and subsequent manual searches were utilized to identify articles in which C677T and A1298C MTHFR polymorphisms were evaluated in RA patients taking MTX. A meta-analysis was conducted to identify associations between MTHFR polymorphisms and MTX toxicity. Twelve studies comprising a total of 2,288 RA patients were included in our meta-analysis. Meta-analysis revealed an association between the overall toxicity of MTX and the MTHFR 677TT genotype (odds ratio [OR] = 1.615, 95 % confidence interval [CI] = 1.185-2.200, p = 0.002). Stratification by ethnicity indicated an association between the MTHFR 677TT genotype and the overall toxicity of MTX in East Asians (OR = 1.583, 95 % CI = 1.075-2.331, p = 0.020). The toxicity of MTX also was found to be associated with the TT genotype in patients taking folate (OR = 1.893, 95 % CI = 1.283-2.793, p = 0.001). Stratification by toxicity type indicated an association between the MTHFR 677TT genotype and any adverse effects (OR = 1.716, 95 % CI = 1.127-2.612, p = 0.012). Meta-analysis stratified by toxicity type indicated an association between the MTHFR 1298CC genotype and any adverse effects (OR = 0.501, 95 % CI = 0.284-0.886, p = 0.017). The results of our meta-analysis suggest that the MTHFR C677T and A1298C polymorphisms are associated with MTX toxicity in RA patients. | |
24767138 | Characteristics of lumbar scoliosis in patients with rheumatoid arthritis. | 2014 Apr 26 | BACKGROUND: Although a substantial percentage of patients with rheumatoid arthritis (RA) experience low back pain, the characteristics of lumbar spine pathology in RA patients has been poorly investigated. In our institutions, lumbar spine radiographs indicated scoliosis in 26 patients. The present study aimed to clarify the characteristics of lumbar scoliosis in RA patients. METHODS: This is a retrospective study of 26 RA patients with lumbar scoliosis. Patient characteristics such as disease duration, disease stage and class according to Steinbrocker's classification, and medication for RA and osteoporosis were reviewed. Radiologic evaluation of scoliosis was performed at two different time points by measuring Cobb angles. The progression of scoliosis per year was calculated by dividing the change in Cobb angles by the number of years. Apical vertebral rotation, lateral listhesis, and the level of the intercrestal line at the first observation were also measured. The correlation between different factors and changes in the Cobb angles per year was analyzed. RESULTS: Majority of the patients had a long disease duration and were classified as stage 3 or 4 according to Steinbrocker's classification. During the observation period, most patients were treated with glucocorticoids. Unlike the previous studies on degenerative scoliosis, apical vertebral rotation, lateral listhesis, and the level of the intercrestal line at initial observation were not significantly related to the progression of scoliosis. Initial Cobb angles were inversely related to the progression of scoliosis. Patients who were treated with bisphosphonates showed slower progression of scoliosis. CONCLUSIONS: Our results indicate that the characteristics of lumbar scoliosis in RA patients differ from those of degenerative lumbar scoliosis. Bone fragility due to the long disease duration, poor control of disease activity, and osteoporosis is possibly related to its progression. | |
25169728 | Clinical and radiographic outcomes at 2 years and the effect of tocilizumab discontinuat | 2015 Jan | OBJECTIVE: To assess the efficacy and safety of tocilizumab (TCZ) plus methotrexate/placebo (MTX/PBO) over 2 years and the course of disease activity in patients who discontinued TCZ due to sustained remission. METHODS: ACT-RAY was a double-blind 3-year trial. Patients with active rheumatoid arthritis despite MTX were randomised to add TCZ to ongoing MTX (add-on strategy) or switch to TCZ plus PBO (switch strategy). Using a treat-to-target approach, open-label conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), other than MTX, were added from week 24 if Disease Activity Score in 28 joints based on erythrocyte sedimentation rate (DAS28-ESR) >3.2. Between weeks 52 and 104, patients in sustained clinical remission (DAS28-ESR <2.6 at two consecutive visits 12 weeks apart) discontinued TCZ and were assessed every 4 weeks for 1 year. If sustained remission was maintained, added csDMARDs, then MTX/PBO, were discontinued. RESULTS: Of the 556 randomised patients, 76% completed year 2. Of patients entering year 2, 50.4% discontinued TCZ after achieving sustained remission and 5.9% achieved drug-free remission. Most patients who discontinued TCZ (84.0%) had a subsequent flare, but responded well to TCZ reintroduction. Despite many patients temporarily stopping TCZ, radiographic progression was minimal, with differences favouring add-on treatment. Rates of serious adverse events and serious infections per 100 patient-years were 12.2 and 4.4 in add-on and 15.0 and 3.7 in switch patients. In patients with normal baseline values, alanine aminotransferase elevations >3×upper limit of normal were more frequent in add-on (14.3%) versus switch patients (5.4%). CONCLUSIONS: Treat-to-target strategies could be successfully implemented with TCZ to achieve sustained remission, after which TCZ was stopped. Biologic-free remission was maintained for about 3 months, but most patients eventually flared. TCZ restart led to rapid improvement. TRIAL REGISTRATION NUMBER: NCT00810199. | |
24202616 | Lack association of body mass index with disease activity composites of rheumatoid arthrit | 2014 Apr | The debate regarding the influence of body mass index (BMI) on clinical disease activity in rheumatoid arthritis (RA) remains unsolved. This study investigates whether BMI is associated with disease activity composites and clinical parameters in Korean patients with RA. A total of 568 patients with RA were consecutively enrolled in this study. BMI and disease activity composites including the Disease Activity Score 28 (DAS28) and the Clinical/Simplified Disease Activity Index (CDAI/SDAI) were assessed. Statistical analyses were performed using Chi-square, one-way ANOVA, and multivariate regression analyses. Remission of RA disease activity was defined as ≤2.6 in a DAS28 score. The mean BMI was 22.3 kg/m(2) (SD 3.1). About 60.6 % (n = 344) of enrolled patients fell into the underweight and normal BMI categories. Swollen joint count was significantly different among the four BMI categories (p = 0.038). Multivariate regression analysis showed a negative correlation of BMI and erythrocyte sediment rate (ESR) in all patients (β= - 0.011, p = 0.049) and also found that other disease activity indices were not found to be associated with BMI. In patients with remission, lower BMI was associated with higher physician global estimate (β= - 0.446, p = 0.030). The negative association between BMI and ESR in the non-remission group was noted (β= - 0.016, p = 0.019). This study revealed lack association between BMI and disease activity composites of RA, although only ESR was found to be associated with BMI in RA patients. | |
24773941 | The positive influence of methotrexate on the mortality of patients with rheumatoid arthri | 2014 May | OBJECTIVES: Methotrexate (MTX) is the anchor drug in the treatment of patients with rheumatoid arthritis (RA). MTX shows effects on disease activity and mortality. However, it is unclear whether the effect of MTX on mortality depends on its effect on disease activity. METHODS: In a post-hoc analysis we analysed the data of our cohort established in Ratingen, Germany, and included all patients starting treatment with MTX (n=271) between 1980 and 1987. One year after baseline (BL), response to MTX treatment was assessed using a modified ACR 20 response. Follow-up data of 250 patients were available after 10 and 18 years. RESULTS: After 1 year, there were 66% responders and 20% non-responders; only 14% had discontinued MTX treatment due to side effects or lack of efficacy. Most patients continued MTX treatment irrespective of efficacy. Ten years after BL, 61% of the patients were still treated with MTX. After 18 years, the responder-group showed a standardised mortality ratio of 1.6 compared to 3.2 for the group of non-responders. However, when adjusting for age, gender, response to MTX treatment one year after BL, number of swollen joints and comorbidities after 10 years an independent association of continued MTX treatment with lower mortality was found for the period 10 to 18 years after BL (hazard ratio (HR): 0.63, 95% confidence interval: 0.43-0.92, p=0.015). CONCLUSIONS: In this cohort, the mortality lowering effect of continued MTX use was partly independent of its effect on disease activity. This finding may affect treatment decisions concerning RA patients with insufficient response to MTX. | |
25373782 | Whole mitochondrial genome sequence of a rat rheumatoid arthritis E3 strain. | 2016 May | We sequenced a complete mitochondrial genome sequence of a rat rheumatoid arthritis disease E3 strain for the first time. The total length of the mitogenome was 16,305 bp and coding 13 protein-coding genes, 2 ribosomal RNA genes, 22 transfer RNA genes. This mitochondrial genome sequence will provide new genetic resource into rheumatoid arthritis disease. | |
25537265 | Multivariate meta-analysis helps examine the impact of outcome reporting bias in Cochrane | 2015 May | OBJECTIVES: Outcome reporting bias (ORB) is a threat to validity of systematic reviews. Multivariate meta-analysis (MVMA) can potentially reduce the impact of ORB when outcomes are correlated. The aim of this study was to assess ORB in Cochrane systematic reviews of rheumatoid arthritis and to demonstrate how MVMA may examine its impact. STUDY DESIGN AND SETTING: Reviews were assessed for ORB in relation to eight outcomes for rheumatoid arthritis using a nine-point classification system. Impact of ORB was assessed by comparing estimates from univariate meta-analysis and MVMA models. RESULTS: ORB assessment was applied in 21 included reviews, and all contained missing data on at least one of the eight outcomes. ORB was highly suspected in 247 (22%) of the 1,118 evaluable outcomes from 155 assessable trials. MVMA and univariate results sometimes differed importantly. The maximum change in treatment effect estimate between MVMA and univariate meta-analysis approach was found to be 176% for one of the outcome considered. CONCLUSION: ORB has the potential to affect the conclusions in meta-analyses. This could be avoided if trialists reported on all measured outcomes in full. If missing outcome data are unobtainable, MVMA is useful to examine the impact of missing outcomes and ORB on conclusions. | |
23529819 | Association of variants in IL2RA with progression of joint destruction in rheumatoid arthr | 2013 Jul | OBJECTIVE: Heritability studies have suggested an important role of genetic predisposition in the progression of joint destruction in rheumatoid arthritis (RA); the heritability is estimated at 45-58%. Several single-nucleotide polymorphisms (SNPs) have been identified as being associated with RA susceptibility. Our objective was to study the association of several of these loci with progression of joint destruction. METHODS: We studied 1,750 RA patients in 4 independent data sets with 4,732 radiographs scored using the modified Sharp/van der Heijde method. Thirteen susceptibility SNPs that were not previously associated with joint destruction were tested in 596 Dutch RA patients. Subsequently, significant SNPs were studied in data sets of RA patients from North America and Iceland. Data were summarized in inverse-weighted variance meta-analyses. Further, the association with circulating protein levels was studied and the associated region was fine-mapped. RESULTS: In stage 1, 3 loci (AFF3, IL2RA, and BLK) were significantly associated with the rate of joint destruction and were further analyzed in the additional data sets. In the combined meta-analyses, the minor (C) allele of IL2RA (rs2104286) was associated with less progression of joint destruction (P = 7.2 × 10(-4) ). Furthermore, the IL2RA (rs2104286) protective genotype was associated with lower (0.85-fold [95% confidence interval 0.77-0.93], P = 1.4 × 10(-3) ) circulating levels of soluble interleukin-2 receptor α (sIL-2Rα). Additionally, lower sIL-2Rα levels were associated with a lower rate of joint destruction (P = 3.4 × 10(-3) ). The association of IL2RA with the rate of joint destruction was further localized to a 40-kb region encompassing the IL2RA intron 1 and the 5' region of IL2RA and RBM17. CONCLUSION: The present genetic and serologic data suggest that inherited altered genetic constitution at the IL2RA locus may predispose to a less destructive course of RA. | |
22911136 | Tuberculous pleurisy diagnosed by medical thoracoscopy in an adalimumab-treated rheumatoid | 2013 Sep | A 28-year-old rheumatoid arthritis woman treated with adalimumab was admitted with fever, cough, and right chest pain. X-ray showed right pleural effusion. By medical thoracoscopy, diffuse white nodules were observed, and biopsy specimen demonstrated epithelioid cell granulomas with necrosis and auramine-stained organisms, which suggested a diagnosis of tuberculous pleurisy. Medical thoracoscopy can be a potent diagnostic method when tuberculous pleurisy is suspected. Notably, despite latent tuberculosis treatment, active tuberculosis was not prevented. | |
24372368 | Methotrexate-induced pneumonitis: heterogeneity of bronchoalveolar lavage and differences | 2014 Feb | PURPOSE: Our knowledge on bronchoalveolar lavage (BAL) of methotrexate-induced pneumonitis (MTX-P) is fragmentary and based on data that are sometimes apparently conflicting. Aim of this review was to provide a comprehensive overview on the BAL features of MTX-P arising from cases published to date, and to determine the cytological patterns and any differences between cancer and rheumatoid arthritis patients, the two patient subsets among which this complication more often occurs. METHODS: English-language articles published up to November 2013 were systematically searched through PUBMED, EMBASE, and other databases. Adult patients with a proven diagnosis of MTX-P and careful mention of each BAL parameter were examined. RESULTS: Seventeen articles for a total of 47 patients were included. Four BAL patterns with a variably combined lymphocytosis and two with prominent neutrophilia were identified. A more intense lymphocytosis (P=0.004) and a more depressed CD4/CD8 ratio (P=0.01) were found in cancer patients compared with rheumatoid arthritis patients. CONCLUSIONS: In MTX-P, cytological analysis of BAL may disclose up to six different patterns. In MTX-P affecting cancer patients, BAL tends to show the typical features of hypersensitivity pneumonitis, while, in rheumatoid arthritis patients, it is more heterogeneous, with a less intense lymphocytosis, a more pronounced neutrophilia, and a higher CD4/CD8 ratio. These differences could be related to a disparity in baseline pulmonary conditions between the two background diseases, i.e., to the presence of previously healthy lungs in cancer patients, and lungs already involved by the immune-mediated inflammatory processes, often not manifestly, in rheumatoid arthritis patients. | |
24821680 | Time trends in glucocorticoid use in rheumatoid arthritis: results from a population-based | 2014 Oct | OBJECTIVE: To examine trends in glucocorticoid (GC) use and dosing among patients diagnosed with rheumatoid arthritis (RA) over time. METHODS: A population-based inception cohort of RA patients diagnosed during 1980-2007 was followed longitudinally through their medical records until death, migration, or December 31, 2008. GC start and stop dates were collected, along with doses in prednisone equivalents. RESULTS: The study population comprised 349 patients (68% women) diagnosed in 1980-1994 and 464 (69% women) diagnosed in 1995-2007, with a median followup of 15.3 and 5.7 years, respectively. A higher proportion of patients started GCs in their first year of disease in 1995-2007 (68% versus 36%; P < 0.001), but the starting dose (mean 8.7 versus 10.3 mg; P = 0.08) and cumulative dose in the first year of use (mean 1.8g [mean daily dose 4.9 mg] versus 2.1 gm [mean daily dose 5.8 mg]; P = 0.48) were not different. A higher proportion also discontinued GCs in their first year of disease in the 1995-2007 cohort (P < 0.001). These differences in GC initiation and discontinuation persisted throughout followup. Prevalence of GC use was higher in the 1995-2007 cohort for the first 3 years of disease. CONCLUSION: More patients are starting GCs early in their disease course now compared to previously, which is consistent with established treatment guidelines. A higher proportion are also discontinuing GCs, but the proportion of patients taking GCs at any given point of disease during the first 4 years is higher now than previously. Despite early addition of a disease-modifying antirheumatic drug, some patients may not be able to discontinue GCs over the long term. | |
24657898 | The use of biosimilars in immune-mediated disease: A joint Italian Society of Rheumatology | 2014 Jul | Biological agents are widely used in rheumatology, dermatology and inflammatory bowel disease. Evidence about their efficacy and safety has been strengthened for all those therapeutic indications over the last decade. Biosimilar agents are monoclonal antibodies similar to previously approved biologics. In the European Union, they have been approved for all the indications in the management of immune-mediated inflammatory diseases (IMIDs), although data only in rheumatoid arthritis and ankylosing spondylitis are currently available. Direct evidence on efficacy, safety, and immunogenicity of biosimilars is mandatory in psoriasis, psoriatic arthritis, and inflammatory bowel disease, as well as in children. Based on the current evidence in the literature, we present the joint official position of the Italian Societies of Rheumatology, Dermatology and Inflammatory Bowel Disease on the use of biosimilars in IMIDs. | |
24688450 | Application of liposomes in treatment of rheumatoid arthritis: quo vadis. | 2014 | The most common treatments for rheumatoid arthritis include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, disease modifying antirheumatic drugs (DMARDs), and some biological agents. However, none of the treatments available is able to achieve the ultimate goal of treatment, that is, drug-free remission. This limitation has shifted the focus of treatment to delivery strategies with an ability to deliver the drugs into the synovial cavity in the proper dosage while mitigating side effects to other tissues. A number of approaches like microemulsions, microspheres, liposomes, microballoons, cocrystals, nanoemulsions, dendrimers, microsponges, and so forth, have been used for intrasynovial delivery of these drugs. Amongst these, liposomes have proven to be very effective for retaining the drug in the synovial cavity by virtue of their size and chemical composition. The fast clearance of intra-synovially administered drugs can be overcome by use of liposomes leading to increased uptake of drugs by the target synovial cells, which in turn reduces the exposure of nontarget sites and eliminates most of the undesirable effects associated with therapy. This review focuses on the use of liposomes in treatment of rheumatoid arthritis and summarizes data relating to the liposome formulations of various drugs. It also discusses emerging trends of this promising technology. | |
25070712 | MiRNAs in bone diseases. | 2013 | MicroRNAs (miRNAs), which mainly inhibit protein expression by targeting the 3'UTR (untranslated region) of mRNAs, are known to play various roles in the pathogenesis of many different types of diseases. Specifically, in bone diseases, recent emphasis has been placed on the involvement of miRNAs in the differentiation and proliferation of bone and cartilage cells, particularly with regards to how these mechanisms contribute to bone homeostasis. In this review, we summarize miRNAs that are important in the differentiation and proliferation of bone cells, and specific miRNAs associated with bone diseases, such as osteoporosis, osteoarthritis and rheumatoid arthritis. This review also provides the perspective that miRNA studies will identify not only new mechanisms in basic bone research, but also potential novel diagnostic biomarkers and drug targets for bone diseases. | |
24517212 | Health-related quality of life and functional ability in patients with early arthritis dur | 2013 Oct 31 | INTRODUCTION: The aim of this study was to investigate patient reported outcomes (PROs) of functional ability and health related quality of life (HRQoL) in patients with early (rheumatoid) arthritis during one year of remission steered treatment. METHODS: In this study, 610 patients with early rheumatoid arthritis (RA) or undifferentiated arthritis (UA) were treated with methotrexate (MTX) and tapered high dose of prednisone. Patients in early remission (Disease Activity Score (DAS) <1.6 after 4 months) tapered prednisone to zero and when in persistent remission, also tapered MTX. Patients not in early remission were randomized to either MTX + hydroxychloroquine + sulphasalazine + prednisone (arm 1) or to MTX + adalimumab (arm 2). Every 4 months, patients filled out the Health Assessment Questionnaire (HAQ) and the McMaster Toronto Arthritis Patient Preference Questionnaire (MACTAR), the Short Form 36 (SF-36) and visual analogue scales (VAS). Change scores were compared between treatment groups. The association with achieving remission was analyzed using linear mixed models. RESULTS: During year 1, patients who achieved early remission had the most improvement in PROs with scores comparable to the general population. Patients in the randomization arms showed less improvement. Scores were comparable between the arms. There was a significant association between achieving remission and scores of HAQ, MACTAR and physical HRQoL. CONCLUSIONS: In early arthritis, PROs of functional ability and HRQoL after one year of remission steered treatment reach normal values in patients who achieved early remission. In patients not in early remission, who were randomized to two strategy arms, PROs improved less, with similar scores in both treatment arms. TRIAL REGISTRATIONS: ISRCTN11916566 and EudraCT2006-006186-16. | |
24430034 | [Neurogenic mechanisms of chronic joint pain]. | 2013 | To study pathogenetic features of chronic joint pain, we examined 183 patients with rheumatoid arthritis (RA) and 80 patients with osteoarthrosis (OA). The presence of mixed pain syndrome was found. A neuropathic component of pain (NCP) was observed in some patients with nociceptive pain (43 and 30% with RA and OA, respectively). Patients with RA had tunnel syndromes (14%), polyneuropathies (55%), mononeuropathies (19%) and sensitive specific disorders, characteristic of NCP, which were localized in anatomic zones corresponding to affected nerves. No signs of the damage of the somatosensory nervous system were found in patients with OA. Neuropathic pain was concomitant to secondary hyperalgesia which covered the zones localized far from the affected joint that allowed to suggest the involvement of dysfunctional mechanisms in the pathogenesis of chronic pain in OA. The study opens new possibilities for pharmacotherapy. | |
24800524 | [Effect of galantamine and testosterone on the arthritic response and dopamine content in | 2014 | The study was carried out on male Wistar rats with surgically ablated gonads. The rats with gonadectomy and intact rats received galantamine and/or testosterone over 10 days, after which the model arthritis was induced by injection of 200 ml of complete Freund's adjuvant. It was established that gonadectomy reduced arthritic reactions producing ulcer formation at a later time (21 days) as compared to control (rats with arthritis), where they are formed on the local stage of development (day 7). Testosterone replacement therapy completely blocks the development of ulcers on the paws. Galantamine suppresses the arthritic reaction more significantly, reducing paws and ankle-joint edema 1.5 and 1.3 times respectively (n = 12, p <0.05). The appearance of dopamine in the spleen during galantamine treatment may serve as a marker of protective action of the drug under hypoandrogenic conditions. Introduction of galantamine at high level of testosterone does not significantly influence on development of arthritic reaction, which is indicative of a marked imbalance between the hormonal and cholinergic systems and a possibility to modulate arthritic reaction with cholinergic drugs. | |
25748133 | Five-year administration of tocilizumab to a patient with rheumatoid arthritis complicated | 2014 | We herein described the long-term administration of tocilizumab (TCZ) to a patient with rheumatoid arthritis (RA) complicated by three vessel coronary artery disease and severe heart failure (HF). A 41-year-old male was admitted to our hospital with exacerbated RA and congestive HF. Cardiac ultrasonography revealed diffuse hypokinesis with a left ventricular ejection fraction (LVEF) of 16.8% and New York Heart Association (NYHA) class III/IV HF. Swelling and tenderness were noted in most of his joints. Methotrexate (MTX) was initiated during his hospitalization and TCZ was introduced 6 months later. Our patient has been treated with MTX and TCZ for five years without any adverse events, and RA and HF have remained stable. Although it may be anecdotal, we suggest that TCZ may be used as a treatment option in patients with RA complicated by severe HF. | |
24093565 | Assessing synovitis based on dynamic gadolinium-enhanced MRI and EULAR-OMERACT scores of t | 2013 Nov | OBJECTIVES: The objective of this study was to correlate dynamic contrast-enhanced MRI (DCE-MRI) perfusion parameters and conventional MRI scored with RAMRIS acquired from the wrists of patients with rheumatoid arthritis (RA). METHODS: Fifty-nine RA patients had conventional and DCE-MRI of the wrist using a low-field 0.2T ESAOTE extremity scanner. Synovitis, bone oedema and bone erosions were assessed using RAMRIS. DCE-MRI data were analysed using dedicated software Dynamika resulting in a set of perfusion parameters. RESULTS: RAMRIS synovitis score and the number of enhancing pixels in DCE-MRI images have shown significant correlation. In this study, the parameters reflecting the dynamics of MRI signal enhancement (maximum enhancement, initial enhancement rate and the time of onset of enhancement) did not correlate with RAMRIS synovitis score, with bone oedema and with bone erosions scores. CONCLUSIONS: One-way analysis of variance leads to conclusions consistent with the correlation analysis. There were cases of inflammation seen in axial images of a 3D T1-weighed gradient echo sequence not reflected in the perfusion data. |