title: 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.
abstract: OBJECTIVE
  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 RAMRIS(erosion) 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 RAMRIS(erosion) (OR 1.25, 95% CI 1.09 to 1.43, p=0.0013, area under the curve=0.78).
  
  
  CONCLUSIONS
  BME is a predictive factor of MRI-determined structural progression in patients with RA in clinical remission or with LDA.
authors.affiliation: Department of Rheumatology, Pitie Salpetriere Hospital, APHP, Université Paris-UPMC, France. frederique.gandjbakhch@psl.aphp.fr
authors.forename: F
authors.initials: F
authors.lastname: Gandjbakhch
authors.forename: V
authors.initials: V
authors.lastname: Foltz
authors.forename: A
authors.initials: A
authors.lastname: Mallet
authors.forename: P
authors.initials: P
authors.lastname: Bourgeois
authors.forename: B
authors.initials: B
authors.lastname: Fautrel
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D001855:Bone Marrow Diseases / Q000175:diagnosis / Q000209:etiology*; D018450:Disease Progression; D004487:Edema / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008662:Metacarpophalangeal Joint / Q000473:pathology; D008875:Middle Aged; D012074:Remission Induction; D012720:Severity of Illness Index; D013585:Synovitis / Q000175:diagnosis / Q000209:etiology; D014955:Wrist Joint / Q000473:pathology
chemical_list: D018501:Antirheumatic Agents