Objectives To identify the predictive factors of MRI-determined structural progression in patients with rheumatoid arthritis (RA) in remission or with low disease activity (LDA).
Methods In this 1-year longitudinal study, patients with RA in clinical remission (disease activity score (DAS) 44≤1.6) or with LDA (1.6<DAS 44≤2.4) underwent low-field MRI of the dominant hand at baseline and at 6 and 12 months. MRI images were scored by the rheumatoid arthritis MRI system (RAMRIS) by rheumatologists blind to clinical and biological data. Structural progression was defined as a change in the RAMRISerosion score between baseline and 1 year greater than the smallest detectable difference. Predictive factors of structural disease progression were analysed by logistic and linear regression.
Results 85 patients with RA in remission (n=47) or with LDA (n=38) were included. Their mean age was 50±13 years, 81% were female, mean disease duration was 35±20 months, rheumatoid factor (RF)/anti-CCP positivity was 63%/64% and 77% had radiographic erosion. At baseline most patients showed inflammatory activity on MRI: 87% had at least one synovitis and 23% at least one location of bone marrow oedema (BME). BME at baseline was predictive of change in RAMRISerosion (OR 1.25, 95% CI 1.09 to 1.43, p=0.0013, area under the curve=0.78).
Conclusion BME is a predictive factor of MRI-determined structural progression in patients with RA in clinical remission or with LDA.
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Patient consent Written informed consent was obtained from all subjects before study inclusion.
Ethics approval This study was conducted with the approval of the URC Pitie Salpetriere, Paris, France.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed
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