title: Efficacy of golimumab for preventing large joint destruction in patients with rheumatoid arthritis as determined by the ARASHI score.
abstract: OBJECTIVE
  The objective of this study is to investigate the inhibitory effect of golimumab on large joint destruction in patients with rheumatoid arthritis.
  
  
  METHODS
  We recruited 45 patients with rheumatoid arthritis and evaluated the radiographic severity of large joint destruction using the assessment of rheumatoid arthritis by scoring of large joint destruction and healing in radiographic imaging (ARASHI) score. We evaluated 450 large joints including the elbow, shoulder, hip, knee, and ankle at baseline and 52 weeks after treatment with golimumab. Rapid radiographic progression (RRP) and rapid radiographic improvement (RRI) were calculated and the correlation between large joint destruction and clinical factors was analyzed.
  
  
  RESULTS
  The mean age of the study population was 61.29 ± 14.71 years old, and most patients (91.1%) were female. The mean disease duration was 12.6 ± 12.48 years. The cohort included patients in all clinical stages of disease as defined by the Steinbroker criteria (I:7, II:10, III:9, IV:19) as well as clinical classes 2 (n = 18), 3 (n = 26), and 4 (n = 1) and the mean disease activity score-CRP (DAS28-CRP) was 4.431 ± 1.044. Patients were treated with methotrexate (mean dose 6.44 ± 1.78 mg/week), prednisolone (PSL) (mean dose 1.078 ± 1.871 mg/d), and golimumab (44.4% of 100 mg). RRP was evident in 20% of the large joints treated with golimumab, and, therefore, golimumab was effective at inhibiting large joint destruction in 80% of joints. RRI was evident in 33.3% of large joints following golimumab treatment. We also observed that EULAR response criteria significantly correlated with the ARASHI change score at 52 weeks after treatment. The total ARASHI status score significantly correlated with the Sharp-van der Heijde score, but not with the delta total sharp score. Multiple regression analyses revealed that the total ARASHI change score was only correlated with EULAR response criteria significantly.
  
  
  CONCLUSIONS
  Golimumab therapy was effective at inhibiting large joint destruction of RA patients who have good clinical response, including higher improvement of the shoulder and ankle joints than other large joints.
authors.affiliation: a Department of Orthopaedic Surgery , Tokyo Women's Medical University, Medical Center East , Tokyo , Japan.
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Kanbe
authors.affiliation: a Department of Orthopaedic Surgery , Tokyo Women's Medical University, Medical Center East , Tokyo , Japan.
authors.forename: Koei
authors.initials: K
authors.lastname: Oh
authors.affiliation: a Department of Orthopaedic Surgery , Tokyo Women's Medical University, Medical Center East , Tokyo , Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Chiba
authors.affiliation: a Department of Orthopaedic Surgery , Tokyo Women's Medical University, Medical Center East , Tokyo , Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Inoue
authors.affiliation: a Department of Orthopaedic Surgery , Tokyo Women's Medical University, Medical Center East , Tokyo , Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Taguchi
authors.affiliation: a Department of Orthopaedic Surgery , Tokyo Women's Medical University, Medical Center East , Tokyo , Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Yabuki
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; C529000:golimumab; D011239:Prednisolone; D008727:Methotrexate
keywords: ARASHI score; Large joint; biologics; golimumab; rheumatoid arthritis