Objectives To define criteria based on the OMERACT rheumatoid arthritis MRI score (RAMRIS) which correspond to the 1-year EULAR response in a cohort of patients with rheumatoid arthritis.
Methods 94 patients (62 female and 32 male patients) with rheumatoid arthritis from the RemissionPLUS cohort starting with disease-modifying drugs or biologic agents and underwent low-field MR images of the dominant hand at baseline and after 12 months were included in this retrospective study. The 1-year treatment response was assessed by EULAR response criteria and OMERACT rheumatoid arthritis MRI score (RAMRIS). Spearman correlations between baseline and follow-up clinical (DAS28, CRP, ESR) and MRI findings (total RAMRIS, RAMRIS subscores) were calculated. Receiver operating curve analysis was performed to test if the 1-year EULAR response could be predicted by the change of the RAMRIS score from baseline- to follow-up MRI (ΔRAMRIS).
Results After one year 51 patients (54.3%) showed a good, 22 (23.4%) a moderate and 18 (19.1%) a poor EULAR response. The correlations between clinical parameters and RAMRIS scores were weak at baseline and follow-up; the same was true for the score changes from baseline to follow-up. The likelihood of a good and poor EULAR response could be predicted by the ΔRAMRIS (P <0.05). The AUC for the prediction of a good response and poor response was 0.63 and 0.71, respectively. The ΔRAMRIS values for 60, 70, 80, 90 and 99% probability for a good and poor response were -17, -35, -59, -93, -196 and 22, 29, 38, 50, 88, respectively. The probability of a moderate EULAR response could not be predicted by ΔRAMRIS (p=0.99).
Conclusions The course of joint inflammation rated with the RAMRIS could predict the probability of a good and poor but not moderate therapy response according to the EULAR criteria. We propose the use of Δ RAMRIS thresholds to identify patients with a good or poor therapy response. These data provide the first step towards MRI response criteria in RA and need further evaluation and approval.
Acknowledgements This study was supported by Abbott Immunology Germany (Dr. B. Wolff) and Esoate GmbH Deutschland (D. Pütz, W. van Kemenade).
Disclosure of Interest None declared