title: Early MRI measures independently predict 1-year and 2-year radiographic progression in rheumatoid arthritis: secondary analysis from a large clinical trial.
abstract: OBJECTIVE
  To determine if early MRI measures predict X-ray progression at 1 and 2 years in a large RA trial cohort.
  
  
  METHODS
  This study included 256 methotrexate (MTX)-naïve RA patients from a randomised placebo-controlled trial of golimumab (GO-BEFORE). MRIs of wrist and 2nd-5th metacarpophalangeal joints at 0, 12, 24, 52 and 104 weeks were obtained and scored using the RAMRIS system. Multivariable logistic regression examined if baseline and early change (weeks 12/24) in RAMRIS scores independently predicted progression of the van der Heijde-Sharp (vdHS) score and MRI erosion score at 1 and 2 years of follow-up.
  
  
  RESULTS
  High baseline score and poor improvement over the first 24 weeks in synovitis (p=0.003 and p=0.003, respectively) and in bone oedema (p=0.02 and p=0.001, respectively) were independent predictors of X-ray progression at 1 year. Associations were significant or tended towards an association at 2 years. An increase in RAMRIS bone erosion >0.5 at weeks 12 and 24 also predicted X-ray progression (p<0.003). Poor 12-week improvement in bone oedema was associated with X-ray and MRI progression at 1 year (p<0.05). Regression models that incorporated baseline and 12-week and 24-week changes in MRI measures of synovitis (AUC=0.71) and bone oedema (AUC=0.70) improved the prediction of X-ray progression at 1 year above clinical disease activity alone (AUC=0.66, p<0.04).
  
  
  CONCLUSIONS
  Baseline and early changes in MRI measures independently predicted X-ray and MRI progression at later time-points. The predictive validity established here supports potential use in shorter-duration studies to determine efficacy of RA therapies in preventing structural damage.
authors.affiliation: University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania, USA.
authors.forename: Joshua F
authors.initials: JF
authors.lastname: Baker
authors.affiliation: Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, USA Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
authors.forename: Mikkel
authors.initials: M
authors.lastname: Ostergaard
authors.affiliation: University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Emery
authors.affiliation: University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania, USA Janssen Research & Development, LLC., Spring House, Pennsylvania, USA.
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Hsia
authors.affiliation: Janssen Research & Development, LLC., Spring House, Pennsylvania, USA.
authors.forename: Jiandong
authors.initials: J
authors.lastname: Lu
authors.affiliation: Janssen Research & Development, LLC., Spring House, Pennsylvania, USA.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Baker
authors.affiliation: University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.
authors.forename: Philip G
authors.initials: PG
authors.lastname: Conaghan
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; 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; D004359:Drug Therapy, Combination; D042241:Early Diagnosis; D004487:Edema / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008662:Metacarpophalangeal Joint / Q000000981:diagnostic imaging / Q000473:pathology; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011859:Radiography; D013585:Synovitis / Q000175:diagnosis / Q000209:etiology; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000473:pathology
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; C529000:golimumab; D008727:Methotrexate
keywords: Disease Activity; Magnetic Resonance Imaging; Rheumatoid Arthritis