title: Predictive factors associated with the progression of large-joint destruction in patients with rheumatoid arthritis after biologic therapy: A post-hoc analysis using FDG-PET/CT and the ARASHI (assessment of rheumatoid arthritis by scoring of large-joint destruction and healing in radiographic imaging) scoring method.
abstract: OBJECTIVE
  To investigate the associations between large-joint damage and findings on fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) using the "assessment of rheumatoid arthritis by scoring of large-joint destruction and healing in radiographic imaging (ARASHI)" scoring system.
  
  
  METHODS
  A total of 270 large joints (shoulders, elbows, hips, knees, and ankles) in 27 rheumatoid arthritis patients were assessed. FDG-PET/CT was performed at the initiation of biologics. Radiographs at baseline and at 3 years were evaluated using the ARASHI score.
  
  
  RESULTS
  Radiographic progression of damage was detected in 35 by Larsen grade vs. 87 by the ARASHI score. The maximum standardized uptake value (SUVmax) at baseline, Steinbrocker stage at baseline, concomitant prednisolone use, and disease activity score in 28 joints based on erythrocyte sedimentation rate (DAS28-ESR) at 6 months were significantly higher in the radiographic progression group. An SUVmax higher than 1.65 at baseline was a significant predictive factor for progressive damage at 3 years.
  
  
  CONCLUSIONS
  The ARASHI score may allow more detailed evaluation of large joints than the Larsen method. Joint destruction is likely to have progressed at 3 years in large joints, which had a higher SUVmax at the initiation of biologics.
authors.affiliation: a Department of Orthopaedic Surgery , Gunma University Graduate School of Medicine , Maebashi , Gunma , Japan.
authors.forename: Takahito
authors.initials: T
authors.lastname: Suto
authors.affiliation: a Department of Orthopaedic Surgery , Gunma University Graduate School of Medicine , Maebashi , Gunma , Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Yonemoto
authors.affiliation: a Department of Orthopaedic Surgery , Gunma University Graduate School of Medicine , Maebashi , Gunma , Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Okamura
authors.affiliation: a Department of Orthopaedic Surgery , Gunma University Graduate School of Medicine , Maebashi , Gunma , Japan.
authors.forename: Chisa
authors.initials: C
authors.lastname: Okura
authors.affiliation: b Department of Orthopaedic Surgery , Inoue Hospital , Takasaki , Gunma , Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kaneko
authors.affiliation: c Department of Physical Therapy , Takasaki University of Health and Welfare , Takasaki , Gunma , Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: a Department of Orthopaedic Surgery , Gunma University Graduate School of Medicine , Maebashi , Gunma , Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tachibana
authors.affiliation: d Department of Diagnostic Radiology and Nuclear Medicine , Gunma University Graduate School of Medicine , Maebashi , Gunma , Japan.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Tsushima
authors.affiliation: a Department of Orthopaedic Surgery , Gunma University Graduate School of Medicine , Maebashi , Gunma , Japan.|e Department of Orthopaedic Surgery , Saint Pierre Hospital , Takasaki , Gunma , Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Takagishi
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000628:therapy; D001691:Biological Therapy / Q000379:methods*; D018450:Disease Progression; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000494:pharmacology; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007596:Joints / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011239:Prednisolone / Q000627:therapeutic use*; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000494:pharmacology; D012107:Research Design; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D005938:Glucocorticoids; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D011239:Prednisolone
keywords: 18F-FDG-PET/CT; ARASHI score; Biologic therapy; Large-joint destruction; Rheumatoid arthritis