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Bone marrow oedema predicts structural progression in a 1-year follow-up of 85 patients with RA in remission or with low disease activity with low-field MRI
  1. F Gandjbakhch1,
  2. V Foltz1,
  3. A Mallet2,
  4. P Bourgeois1,
  5. B Fautrel1
  1. 1Department of Rheumatology, Pitie Salpetriere Hospital, APHP, Université Paris 6-UPMC, Paris, France
  2. 2Department of Statistics, Pitie Salpetriere Hospital, APHP, Université Paris 6-UPMC, Paris, France
  1. Correspondence to Frederique Gandjbakhch, Service de Rhumatologie, CHU Pitié-Salpétrière, 83 boulevard de l’hôpital, 75013 Paris, France; frederique.gandjbakhch{at}psl.aphp.fr

Abstract

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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Footnotes

  • 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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