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AB0278 Mri-Proven Osteitis at Baseline Predicts the Development of RAPID Radiographic Progression at 1 Year toward Patients with Early-Stage Rheumatoid Arthritis: Results from Nagasaki University Early Arthritis Cohort
  1. N. Yoshikazu1,
  2. T. Mami1,
  3. K. Junko1,
  4. T. Ayuko1,
  5. N. Ayako1,
  6. S. Takahisa1,
  7. H. Yoshiro1,
  8. K. Shinya1,
  9. I. Naoki1,
  10. I. Kunihiro1,
  11. A. Kazuhiko2,
  12. N. Hideki1,
  13. O. Tomoki3,
  14. U. Masataka4,
  15. A. Kiyoshi2,
  16. E. Katsumi5,
  17. K. Atsushi1
  1. 1Immunology and Rheumatology
  2. 2Public Health
  3. 3Biomedical Sciences
  4. 4Radiology, Nagasaki University Hospital, Nagasaki
  5. 5Immunology and Rheumatology, Sasebo City General Hospital, Sasebo, Japan


Background EULAR recommendations for the use of imaging of the joints in the clinical management of rheumatoid arthritis (RA) states that magnetic resonance imaging (MRI) bone oedema (osteitis) is a strong independent predictor of subsequent radiographic progression in early RA and should be considered for use as a prognostic indicator. The development of rapid radiographic progression (RRP) is considered as a representative poor outcome in patients with RA.

Objectives We have tried to examine the variables that predict the development of RRP in patients with early-stage RA from Nagasaki University Early Arthritis Cohort.

Methods This is a 1 year observational study from seventy-six early-stage RA patients recruited consecutively from Nagasaki University Early Arthritis Cohort in which the subjects received Gd-enhanced MRI of both wrists and finger joints. All of the patients had been received DMARDs during 1 year. MRI-proven osteitis was scored by Rheumatoid Arthritis Magnetic Resonance Imaging score (RAMRIS). Plain radiographic outcome of both wrists and finger joints was scored by Genant-modified Sharp score and the development of rapid radiographic progression (RRP) at 1 year in this study was identified as a score >3/year. The clinical response toward introduction of DMARDs at 3 months was defined according to DAS28-EULAR response criteria. Variables with a p value less than 0.20 were selected for the following multivariate logistic regression analyses. Starting with a full model, the most appropriate model was selected on the basis of Akaike's information criteria in the SAS system®, version 9.2.

Results Median age and disease duration at entry were 54.5 y.o and 3 months, respectively. The rate of ACPA-positive was 83%. Median RAMRIS osteitis score and that of Genant-modified Sharp score at entry were 1 and 0, respectively. RRP was developed in 12 patients at 1 year. Multivariate logistic regression analyses have identified that RAMRIS osteitis score at baseline (p=0.0009, Odds ratio 1.10, 95% CI 1.04-1.16) and the introduction of biologic DMARDs within 1 year (p=0.044, Odds ratio 5.46, 95% CI 1.05-28.57) are independent predictors toward the development of RRP at 1 year.

Conclusions Present data suggest that MRI-proven osteitis is closely associated with poor radiographic outcome in patients with early-stage RA. The use of biologic DMARDs may reflect the severe disease status.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.5218

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