title: Monitoring anti-interleukin 6 receptor antibody treatment for rheumatoid arthritis by quantitative magnetic resonance imaging of the hand and power Doppler ultrasonography of the finger.
abstract: OBJECTIVE
  To compare quantitative magnetic resonance imaging (MRI) and power Doppler ultrasonography (PDUS) with conventional measures of disease activity in rheumatoid arthritis (RA) patients treated with the anti-interleukin 6 (anti-IL 6) receptor antibody tocilizumab in terms of responsiveness at a few months to disease activity and ability to predict structural damage at 1 year.
  
  
  METHODS
  A cohort of patients with RA (n = 29) was evaluated clinically including disease activity score 28 (DAS28) and by semiquantitative (SQ-) and quantitative (Q-) PDUS (bilateral metacarpophalangeal joints) and MRI (one hand and wrist) at initiation of treatment with anti-IL 6 receptor antibody agents and after 2 and 5 months. Conventional radiography for both hands and wrists was performed at baseline and at 12 months. Responsiveness was assessed by standardized response means (SRM). Areas under the curve (AUC) for measures at baseline, 2 and 5 months were correlated with structural damage at 1 year.
  
  
  RESULTS
  Among the laboratory and clinical parameters, DAS28-ESR was the most responsive with a large effect size of SRM. Structural damage progressions for radiography and MR erosion were correlated with AUC of MR bone erosion and Q-PDUS, respectively.
  
  
  CONCLUSIONS
  In the evaluation of disease activity in RA patients in the first few months after starting anti-IL 6 receptor antibody tocilizumab treatment, the semiquantitative MR bone erosion score of the hand and quantitative value for power Doppler signal in the finger joint were both responsive and predictive of structural damage progression at 1 year.
authors.affiliation: Department of Radiology, Hokkaido University Hospital, N15 W7, Kita-Ku, Sapporo, 0600815, Japan. ktamotamo2@yahoo.co.jp
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Kamishima
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Tanimura
authors.forename: Masato
authors.initials: M
authors.lastname: Shimizu
authors.forename: Megumi
authors.initials: M
authors.lastname: Matsuhashi
authors.forename: Jun
authors.initials: J
authors.lastname: Fukae
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Kon
authors.forename: Hiromi
authors.initials: H
authors.lastname: Hagiwara
authors.forename: Akihiro
authors.initials: A
authors.lastname: Narita
authors.forename: Yuko
authors.initials: Y
authors.lastname: Aoki
authors.forename: Naoki
authors.initials: N
authors.lastname: Kosaka
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Atsumi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Shirato
authors.forename: Satoshi
authors.initials: S
authors.lastname: Terae
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D019540:Area Under Curve; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D015415:Biomarkers / Q000097:blood; D005260:Female; D005384:Finger Joint / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler / Q000379:methods*; D014955:Wrist Joint / Q000473:pathology
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D015415:Biomarkers; C502936:tocilizumab