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Predictors of joint damage progression and stringent remission in patients with established rheumatoid arthritis in clinical remission

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@article{f62c1bde956445498cf0f715518c894a,
title = "Predictors of joint damage progression and stringent remission in patients with established rheumatoid arthritis in clinical remission",
abstract = "OBJECTIVES: To study if clinical, radiographic and MRI markers can predict MRI and radiographic damage progression and achievement of stringent remission in patients with established RA in clinical remission followed by a targeted treatment strategy.METHODS: RA patients (DAS28-CRP <3.2, no swollen joints) receiving conventional synthetic DMARDs were randomized to conventional or MRI-targeted treat-to-target strategies with predefined algorithmic treatment escalations. Potentially predictive baseline variables were tested in multivariate logistic regression analyses.RESULTS: In the 171 patients included, baseline MRI osteitis independently predicted progression in MRI erosion [odds ratio (OR) 1.13 (95% CI 1.06, 1.22)], joint space narrowing [OR 1.15 (95% CI 1.07, 1.24)] and combined damage [OR 1.23 (95% CI 1.13, 1.37)], while tenosynovitis independently predicted MRI erosion progression [OR 1.13 (95% CI 1.03, 1.25)]. A predictor of radiographic erosion progression was age, while gender predicted progression in joint space narrowing. Following an MRI treat-to-target strategy predicted stringent remission across all remission definitions: Clinical Disease Activity Index remission OR 2.94 (95% CI 1.25, 7.52), Simplified Disease Activity Index remission OR 2.50 (95% CI 1.01, 6.66), ACR/EULAR Boolean remission OR 5.47 (95% CI 2.33, 14.13). Similarly, low tender joint count and low patient visual analogue scale pain and global independently predicted achievement of more stringent remission.CONCLUSION: Baseline MRI osteitis and tenosynovitis were independent predictors of 2 year MRI damage progression in RA patients in clinical remission, while independent predictors of radiographic damage progression were age and gender. Following an MRI treat-to-target strategy, low scores of patient-reported outcomes and low tender joint count predicted achievement of stringent remission.TRIAL REGISTRATION: ClinicalTrials.gov (https://clinicaltrials.gov), NCT01656278.",
keywords = "Aged, Antirheumatic Agents/therapeutic use, Arthritis, Rheumatoid/diagnostic imaging, Disease Progression, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Remission Induction, Risk Factors, Severity of Illness Index, Treatment Outcome",
author = "Signe M{\o}ller-Bisgaard and Stylianos Georgiadis and Kim H{\o}rslev-Petersen and Bo Ejbjerg and Hetland, {Merete Lund} and {\O}rnbjerg, {Lykke Midtb{\o}ll} and Daniel Glinatsi and Jakob M{\o}ller and Mikael Boesen and Kristian Stengaard-Pedersen and Madsen, {Ole Rintek} and Bente Jensen and Villadsen, {Jan Alexander} and Ellen-Margrethe Hauge and Philip Bennett and Oliver Hendricks and Karsten Asmussen and Marcin Kowalski and Hanne Lindegaard and Henning Bliddal and Krogh, {Niels Steen} and Torkell Ellingsen and Nielsen, {Agnete H} and Lone Balding and Jurik, {Anne Grethe} and Thomsen, {Henrik S} and Mikkel {\O}stergaard",
note = "COPECARE",
year = "2021",
month = jan,
doi = "10.1093/rheumatology/keaa496",
language = "English",
volume = "60",
pages = "380--391",
journal = "Rheumatology",
issn = "1462-0324",
publisher = "Oxford University Press",
number = "1",

}

RIS

TY - JOUR

T1 - Predictors of joint damage progression and stringent remission in patients with established rheumatoid arthritis in clinical remission

AU - Møller-Bisgaard, Signe

AU - Georgiadis, Stylianos

AU - Hørslev-Petersen, Kim

AU - Ejbjerg, Bo

AU - Hetland, Merete Lund

AU - Ørnbjerg, Lykke Midtbøll

AU - Glinatsi, Daniel

AU - Møller, Jakob

AU - Boesen, Mikael

AU - Stengaard-Pedersen, Kristian

AU - Madsen, Ole Rintek

AU - Jensen, Bente

AU - Villadsen, Jan Alexander

AU - Hauge, Ellen-Margrethe

AU - Bennett, Philip

AU - Hendricks, Oliver

AU - Asmussen, Karsten

AU - Kowalski, Marcin

AU - Lindegaard, Hanne

AU - Bliddal, Henning

AU - Krogh, Niels Steen

AU - Ellingsen, Torkell

AU - Nielsen, Agnete H

AU - Balding, Lone

AU - Jurik, Anne Grethe

AU - Thomsen, Henrik S

AU - Østergaard, Mikkel

N1 - COPECARE

PY - 2021/1

Y1 - 2021/1

N2 - OBJECTIVES: To study if clinical, radiographic and MRI markers can predict MRI and radiographic damage progression and achievement of stringent remission in patients with established RA in clinical remission followed by a targeted treatment strategy.METHODS: RA patients (DAS28-CRP <3.2, no swollen joints) receiving conventional synthetic DMARDs were randomized to conventional or MRI-targeted treat-to-target strategies with predefined algorithmic treatment escalations. Potentially predictive baseline variables were tested in multivariate logistic regression analyses.RESULTS: In the 171 patients included, baseline MRI osteitis independently predicted progression in MRI erosion [odds ratio (OR) 1.13 (95% CI 1.06, 1.22)], joint space narrowing [OR 1.15 (95% CI 1.07, 1.24)] and combined damage [OR 1.23 (95% CI 1.13, 1.37)], while tenosynovitis independently predicted MRI erosion progression [OR 1.13 (95% CI 1.03, 1.25)]. A predictor of radiographic erosion progression was age, while gender predicted progression in joint space narrowing. Following an MRI treat-to-target strategy predicted stringent remission across all remission definitions: Clinical Disease Activity Index remission OR 2.94 (95% CI 1.25, 7.52), Simplified Disease Activity Index remission OR 2.50 (95% CI 1.01, 6.66), ACR/EULAR Boolean remission OR 5.47 (95% CI 2.33, 14.13). Similarly, low tender joint count and low patient visual analogue scale pain and global independently predicted achievement of more stringent remission.CONCLUSION: Baseline MRI osteitis and tenosynovitis were independent predictors of 2 year MRI damage progression in RA patients in clinical remission, while independent predictors of radiographic damage progression were age and gender. Following an MRI treat-to-target strategy, low scores of patient-reported outcomes and low tender joint count predicted achievement of stringent remission.TRIAL REGISTRATION: ClinicalTrials.gov (https://clinicaltrials.gov), NCT01656278.

AB - OBJECTIVES: To study if clinical, radiographic and MRI markers can predict MRI and radiographic damage progression and achievement of stringent remission in patients with established RA in clinical remission followed by a targeted treatment strategy.METHODS: RA patients (DAS28-CRP <3.2, no swollen joints) receiving conventional synthetic DMARDs were randomized to conventional or MRI-targeted treat-to-target strategies with predefined algorithmic treatment escalations. Potentially predictive baseline variables were tested in multivariate logistic regression analyses.RESULTS: In the 171 patients included, baseline MRI osteitis independently predicted progression in MRI erosion [odds ratio (OR) 1.13 (95% CI 1.06, 1.22)], joint space narrowing [OR 1.15 (95% CI 1.07, 1.24)] and combined damage [OR 1.23 (95% CI 1.13, 1.37)], while tenosynovitis independently predicted MRI erosion progression [OR 1.13 (95% CI 1.03, 1.25)]. A predictor of radiographic erosion progression was age, while gender predicted progression in joint space narrowing. Following an MRI treat-to-target strategy predicted stringent remission across all remission definitions: Clinical Disease Activity Index remission OR 2.94 (95% CI 1.25, 7.52), Simplified Disease Activity Index remission OR 2.50 (95% CI 1.01, 6.66), ACR/EULAR Boolean remission OR 5.47 (95% CI 2.33, 14.13). Similarly, low tender joint count and low patient visual analogue scale pain and global independently predicted achievement of more stringent remission.CONCLUSION: Baseline MRI osteitis and tenosynovitis were independent predictors of 2 year MRI damage progression in RA patients in clinical remission, while independent predictors of radiographic damage progression were age and gender. Following an MRI treat-to-target strategy, low scores of patient-reported outcomes and low tender joint count predicted achievement of stringent remission.TRIAL REGISTRATION: ClinicalTrials.gov (https://clinicaltrials.gov), NCT01656278.

KW - Aged

KW - Antirheumatic Agents/therapeutic use

KW - Arthritis, Rheumatoid/diagnostic imaging

KW - Disease Progression

KW - Female

KW - Humans

KW - Magnetic Resonance Imaging

KW - Male

KW - Middle Aged

KW - Remission Induction

KW - Risk Factors

KW - Severity of Illness Index

KW - Treatment Outcome

UR - http://www.scopus.com/inward/record.url?scp=85099428399&partnerID=8YFLogxK

U2 - 10.1093/rheumatology/keaa496

DO - 10.1093/rheumatology/keaa496

M3 - Journal article

C2 - 32929463

VL - 60

SP - 380

EP - 391

JO - Rheumatology

JF - Rheumatology

SN - 1462-0324

IS - 1

ER -

ID: 61652581