Objectives To assess the impact of Tocilizumab on bone oedema in rheumatoid arthritis as shown by MRI
Methods In this longitudinal study, were included patients with rheumatoid arthritis RA according to the American College of Rheumatology ACR 1987 criteria with inadequate response or intolerance to DMARDs, treated with tocilizumab (TCZ).Sociodemographic characteristics, clinical and laboratory for the disease were collected at baseline (M0) and 06 months (M6) of treatment.Disease activity was assessed using DAS28, SDAI et CDAI.MRI of the dominant hand was performed at baseline and M6 of treatment.The primary outcome was the assessment of bone oedema by RAMRIS bone oedema (Rheumatoid Arthritis MRI Scoring system).Secondary outcomes included:RAMRIS synovitis, DAS28 CRP, CRP, and SDAI at baseline and M6.
Results 22 patients with RA were included, 19 females (86.4%), with a mean of age 42±13.7. The mean disease duration was 8±5.2 years.The mean DAS28 was 5.8±0.94. The median CRP was 16 mg/l (6.7 to 36.3). The average SDAI was 90±34. Three patients were excluded from the study for serious side effects.At baseline, bone edema was present in 41% of patients (N=9), with a median bone oedema RAMRIS 0 (0 to 7.2). A M6, bone oedema decreased or disappeared in 32% (N=7) with a significant improvement in the score RAMRIS bone oedema (p=0.04). Moreover, there is a significant improvement RAMRIS synovitis (p<0.0001) as well as activity parameters: DAS28CRP (p <o, ooo1), CRP (p<0.0001) and SDAI (p<0.0001).
Conclusions This study suggests that Tocilizumab is associated with a significant improvement in MRI- determined bone oedema in the short term. This improvement in bone oedema is correlated with improved parameters of disease activity, which could be discussed early structural effect. Further studies are needed to confirm these results.
Disclosure of Interest None declared