Effect of adalimumab on joint disease: features of patients with psoriatic arthritis detected by magnetic resonance imaging
- 1Clinical Immunology Research Center, Allergy, Immunology and Rheumatology Research Division, University of Rochester Medical Center, Rochester, New York, USA
- 2University of Washington, Seattle, Washington, USA
- 3Highline Community Hospital, Burien, Washington, USA
- 4University of Toronto, Toronto, Ontario, Canada
- 5Abbott Laboratories, Parsippany, New Jersey, USA
- Correspondence to Dr A P Anandarajah, Clinical Immunology Research Center, Allergy, Immunology and Rheumatology Research Division, University of Rochester Medical Center, 601 Elmwood Avenue, PO Box 695, Rochester, NY 14642, USA; allen_anandarajah{at}urmc.rochester.edu
- Accepted 23 January 2009
- Published Online First 9 February 2009
Abstract
Background: Bone marrow oedema (BMO), synovitis, effusion and joint erosion on magnetic resonance imaging (MRI) may be used as outcome measures in psoriatic arthritis (PsA).
Objective: To assess the impact of adalimumab on BMO, synovitis, effusion and erosions in PsA, as measured by MRI.
Methods: Fifteen patients with active PsA (≥3 tender and ≥3 swollen joints) were enrolled in an open-label pilot study. Each received adalimumab subcutaneously every other week for 24 weeks. MRI was obtained at baseline and 24 weeks.
Results: MRI was available for 11 patients, pre and post-therapy. BMO and effusion scores improved markedly after 24 weeks of adalimumab, while no significant change was noted in erosion score. An unanticipated finding, however, was the lack of improvement in the MRI synovitis score.
Conclusions: Improvement in BMO and unchanged erosion scores may explain the “anti-erosive” effects of adalimumab in PsA. Persistence of BMO and synovitis on MRI suggests ongoing disease activity and supports the continuation of long-term anti-TNF therapy.
Footnotes
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Competing interests Declared. APA, CF, CTR, PO and DS are study investigators for Abbott Laboratories. RLW is an Abbott employee.
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Ethics approval This study was approved by the Institutional Review Board at the University of Rochester, NY, Medical Center.
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Patient consent Obtained.
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Provenance and Peer review Not commissioned; externally peer reviewed.
