OP0022 DO MRI-DETECTED EROSIONS IN PATIENTS WITH CLINICALLY SUSPECT ARTHRALGIA PREDICT PROGRESSION TO RHEUMATOID ARTHRITIS? A LONGITUDINAL STUDY. (June 2019)

• Record Type: Journal Article
• Authors: Wouters, Fenne; Matthijssen, Xanthe; Boeters, Debbie; Brinck, Robin Ten; van der Helm - van Mil, Annette; Niemantsverdriet, Ellis
• Is Part Of: Annals of the rheumatic diseases. Volume 78(2019)Supplement 2
• Page Start: 77
• Page End: 77
• Publication Date: 2019-06
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2019-eular.2991
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Radiographic joint erosions are a hallmark of Rheumatoid Arthritis (RA). MRI is more sensitive than radiographs in detecting erosions. It is unknown if MRI-detected erosions are predictive for RA-development in patients with Clinically Suspect Arthralgia (CSA). Objectives: We investigated the prognostic value of MRI-detected erosions (any MRI-erosion, or MRI-erosion characteristics that were recently identified as specific for RA) in CSA. Methods: Patients presenting with CSA (n=491) underwent contrast-enhanced 1.5T MRI of the wrist, metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints at baseline. MRIs were scored according to RAMRIS. Presence of any MRI-erosion (erosion score ≥1) and RA-specific erosion characteristics as identified previously (grade ≥2 erosions, erosions in MTP5, erosions in MTP1 if aged <40) were studied with clinically apparent inflammatory arthritis development as outcome (median follow-up 17 months). Analyses were corrected for age, CRP, ACPA and MRI-detected inflammation. Results: Erosions were present in 20.6% of patients. Presence of erosions was not associated with arthritis development (HR multivariable analysis 0.85 (95% CI 0.52-1.40)). Also the different erosion characteristics were not predictive in CSA-patients (grade ≥2 HR 1.29 (95% CI 0.40-4.14), erosions in MTP5 HR 0.89 (95% CI 0.38-2.09) and MTP1 if aged <40 HR 0.98 (95% CI 0.23-4.21)). MRI-erosions were more prevalent in ACPA-positive than in ACPA-negative patients (32.3% versus 18.8%, p=0.02). However, no association with arthritis development was observed in both subgroups. Conclusion: MRI-detected erosions in hands and feet of patients with CSA were not predictive for arthritis development. These data warn against overinterpretation of MRI-detected erosions in CSA. Disclosure of Interests: Fenne Wouters: None declared, Xanthe Matthijssen: None declared, Debbie Boeters: None declared, Robin ten Brinck: None declared, Annette van der Helm - van Mil Grant/research support from: The research leading to these results has received funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme (Starting grant, agreement No 714312) and from the Dutch Arthritis Foundation. The funding source had no role in the design and conduct of the study., Ellis Niemantsverdriet: None declared