title: Correlation of 18F-FDG PET/CT assessments with disease activity and markers of inflammation in patients with early rheumatoid arthritis following the initiation of combination therapy with triple oral antirheumatic drugs.
abstract: OBJECTIVE
  This study evaluated the potential of functional imaging to monitor disease activity and response to treatment with disease-modifying antirheumatic drugs (DMARD) in DMARD-naive patients with early rheumatoid arthritis (RA).
  
  
  METHODS
  The study involved 17 patients with active RA in whom combination therapy was initiated with methotrexate, sulfasalazine, hydroxychloroquine, and low-dose oral prednisolone. Clinical disease activity was assessed at screening, at baseline and after 2, 4, 8 and 12 weeks of therapy. (18)F-FDG PET/CT of all joints was performed at baseline and after 2 and 4 weeks of therapy.
  
  
  RESULTS
  (18)F-FDG maximum standardized uptake values showed a reduction of 22 ± 13 % in 76 % of patients from baseline to week 2 and a reduction of 29 ± 13 % in 81 % of patients from baseline to week 4. The percentage decrease in (18)F-FDG uptake from baseline to week 2 correlated with clinical outcome, as measured by the disease activity score (DAS-28) at week 12. In addition, changes in C-reactive protein levels and erythrocyte sedimentation rate were positively associated with changes shown by PET.
  
  
  CONCLUSIONS
  (18)F-FDG PET/CT findings after 2 and 4 weeks of triple combination oral DMARD therapy correlated with treatment efficacy and clinical outcome in patients with early RA. (18)F-FDG PET/CT may help predict the therapeutic response to novel drug treatments.
authors.affiliation: Turku PET Centre, Turku University Hospital and University of Turku, Kiinamyllynkatu 4-8, 20521, Turku, Finland. anne.roivainen@utu.fi
authors.forename: Anne
authors.initials: A
authors.lastname: Roivainen
authors.forename: Sannamari
authors.initials: S
authors.lastname: Hautaniemi
authors.forename: Timo
authors.initials: T
authors.lastname: Möttönen
authors.forename: Pirjo
authors.initials: P
authors.lastname: Nuutila
authors.forename: Vesa
authors.initials: V
authors.lastname: Oikonen
authors.forename: Riitta
authors.initials: R
authors.lastname: Parkkola
authors.forename: Luminita
authors.initials: L
authors.lastname: Pricop
authors.forename: Rudyard
authors.initials: R
authors.lastname: Ress
authors.forename: Nicholas
authors.initials: N
authors.lastname: Seneca
authors.forename: Marko
authors.initials: M
authors.lastname: Seppänen
authors.forename: Timo
authors.initials: T
authors.lastname: Yli-Kerttula
mesh_terms: D000284:Administration, Oral; D018501:Antirheumatic Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D015415:Biomarkers / Q000378:metabolism; D004338:Drug Combinations; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D015415:Biomarkers; D004338:Drug Combinations; D019788:Fluorodeoxyglucose F18