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Magnetic resonance imaging (MRI) may provide a more complete and accurate assessment of the effect of new therapies on joint destruction and joint inflammation in rheumatoid arthritis (RA) patients than conventional methods. The primary aim of this pilot study was, by means of MRI and radiography, to evaluate changes in joint inflammation and/or destruction in rituximab-treated RA patients.
We included 10 adult RA patients, who, as part of routine clinical practice, were commencing their first treatment course with rituximab. Rituximab was the first biological treatment for six patients (four had a history with cancer and one had a benign neuroendocrine tumour), the remaining patients were previously treated with one to three tumour necrosis factor-alpha antagonists. Rituximab (1000 mg) was administered intravenously at days 0 and 14, preceded by 100 mg methylprednisolone intravenously. High-resolution MRI (voxel size 0.4 × 0.4 × 0.4 mm) of the dominant wrist and second to fifth metacarpophalangeal joints, and radiographs of hands, wrists and forefeet were acquired at baseline, 6 and 12 months. T1-weighted three-dimensional fast-field echo, contrast-enhanced fat-suppressed and short tau inversion …