title: Evaluation of Magnetic Resonance Imaging Responsiveness in Active Psoriatic Arthritis at Multiple Timepoints during the First 12 Weeks of Antitumor Necrosis Factor Therapy.
abstract: OBJECTIVE
  To assess the responsiveness of high- and low-field extremity magnetic resonance imaging (MRI) variables at multiple timepoints in the first 12 weeks post-antitumor necrosis factor (anti-TNF) therapy initiation in patients with psoriatic arthritis (PsA) and active dactylitis.
  
  
  METHODS
  Twelve patients with active PsA and clinical evidence of dactylitis involving at least 1 digit were recruited. Patients underwent sequential high-field conventional (1.5 Tesla) and extremity low-field MRI (0.2 Tesla) of the affected hand or foot, pre- and postgadolinium at baseline (pre-TNF), 2 weeks (post-TNF), 6 weeks, and 12 weeks. A blinded observer scored all images on 2 occasions using the PsA MRI scoring system.
  
  
  RESULTS
  Eleven patients completed the study, but only 6 patients completed all high-field and low-field MRI assessments. MRI scores demonstrated rapid response to TNF inhibition with score reduction in tenosynovitis, synovitis, and osteitis at 2 weeks. Intraobserver reliability was good to excellent for all variables. High-field MRI demonstrated greater sensitivity to tenosynovitis, synovitis, and osteitis and greater responsiveness to change posttreatment. Treatment responses were maintained to 12 weeks.
  
  
  CONCLUSIONS
  This study demonstrates the use of MRI in detecting early response to biologic therapy. MRI variables of tenosynovitis, synovitis, and osteitis demonstrated responsiveness posttherapy with high-field scores more responsive to change than low-field scores.
authors.affiliation: From the Department of Rheumatology, Emeritus Research, Victoria; Department of Rheumatology, Institution for Rehabilitation Research, University of Melbourne, Melbourne; Department of Medicine, University of New South Wales, Sydney, Australia.M. Feletar, MBBS, FRACP, Department of Rheumatology, Emeritus Research; S. Hall, MBBS, BSc, FRACP, Department of Rheumatology, Institution for Rehabilitation Research, University of Melbourne, Emeritus Research; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip Magnetic Resonance Imaging, Conjoint Associate Professor, Department of Medicine, University of New South Wales.
authors.forename: Marie
authors.initials: M
authors.lastname: Feletar
authors.affiliation: From the Department of Rheumatology, Emeritus Research, Victoria; Department of Rheumatology, Institution for Rehabilitation Research, University of Melbourne, Melbourne; Department of Medicine, University of New South Wales, Sydney, Australia.M. Feletar, MBBS, FRACP, Department of Rheumatology, Emeritus Research; S. Hall, MBBS, BSc, FRACP, Department of Rheumatology, Institution for Rehabilitation Research, University of Melbourne, Emeritus Research; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip Magnetic Resonance Imaging, Conjoint Associate Professor, Department of Medicine, University of New South Wales.
authors.forename: Stephen
authors.initials: S
authors.lastname: Hall
authors.affiliation: From the Department of Rheumatology, Emeritus Research, Victoria; Department of Rheumatology, Institution for Rehabilitation Research, University of Melbourne, Melbourne; Department of Medicine, University of New South Wales, Sydney, Australia.M. Feletar, MBBS, FRACP, Department of Rheumatology, Emeritus Research; S. Hall, MBBS, BSc, FRACP, Department of Rheumatology, Institution for Rehabilitation Research, University of Melbourne, Emeritus Research; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip Magnetic Resonance Imaging, Conjoint Associate Professor, Department of Medicine, University of New South Wales. pbird@optimusresearch.com.au.
authors.forename: Paul
authors.initials: P
authors.lastname: Bird
mesh_terms: D000328:Adult; D015535:Arthritis, Psoriatic / Q000188:drug therapy* / Q000473:pathology*; D001315:Australia; D015331:Cohort Studies; D016001:Confidence Intervals; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010147:Pain Measurement / Q000187:drug effects; D011446:Prospective Studies; D012720:Severity of Illness Index; D013717:Tenosynovitis / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000008:administration & dosage* / Q000037:antagonists & inhibitors*
chemical_list: D014409:Tumor Necrosis Factor-alpha
keywords: DACTYLITIS; MAGNETIC RESONANCE IMAGING; PSORIATIC ARTHRITIS; PsAMRIS