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1. Differentiation between early rheumatoid arthritis patients and healthy persons by conventional and dynamic contrast-enhanced magnetic resonance imaging

Author

Axelsen, Mette Bjørndal, Ejbjerg, B J, Hetland, M L, Skjødt, H, Majgaard, O, Lauridsen, Ulrik Birk, Hørslev-Petersen, K, Boesen, M, Kubassova, O, Bliddal, H, Østergaard, Mikkel, Axelsen, Mette Bjørndal, Ejbjerg, B J, Hetland, M L, Skjødt, H, Majgaard, O, Lauridsen, Ulrik Birk, Hørslev-Petersen, K, Boesen, M, Kubassova, O, Bliddal, H, and Østergaard, Mikkel

Abstract

OBJECTIVES: To identify the magnetic resonance imaging (MRI) parameter that best differentiates healthy persons and patients with early rheumatoid arthritis (RA), and to investigated responsiveness to treatment of various MRI parameters.METHOD: Conventional MRI and dynamic contrast-enhanced (DCE)-MRI of the hand were performed once for 26 healthy persons, and before and after 6 and 12 months of disease-modifying anti-rheumatic drug (DMARD) treatment for 14 early RA patients, using a 1.0-T MRI unit. One-slice DCE-MRI was analysed using Dynamika version 4.2. The number of enhancing voxels (Nvoxel), the initial rate of enhancement (IRE), the maximum enhancement (ME), ME×Nvoxel, and IRE×Nvoxel were calculated for wrist and 2nd-5th metacarpophalangeal (MCP) joints. Conventional MR images were evaluated using the RA MRI scoring system (RAMRIS) synovitis score.RESULTS: Using DCE-MRI, enhancement was demonstrated in 61.5% of healthy persons and in 91.7% of RA patients at baseline, with a median Nvoxel of 3 and 362, respectively. At baseline, all parameters were higher for patients than for healthy persons (all p ≤ 0.003). Only one patient had a baseline RAMRIS synovitis score below the 95th percentile of the healthy persons. The corresponding number of patients was 3 for Nvoxel, ME×Nvoxel and IRE×Nvoxel, and 10 for IRE and ME. The RAMRIS synovitis score and IRE showed the highest responsiveness, with a standardized response mean (SRM) of -1.00 and -0.88, respectively.CONCLUSIONS: The RAMRIS synovitis scoring of conventional MRI, and to a lesser extent the one-slice DCE-MRI parameters of synovial volume, differentiated early RA patients and healthy persons. The decrease in RAMRIS synovitis score, Nvoxel, and IRE showed sensitivity to change during treatment.

Published
2014

2. Risk factors for radiographic progression during TNF-inhibitor treatment in 932 rheumatoid arthritis patients treated in clinical practice: Results from the nationwide Danish Danbio Registry.

Author

Ørnbjerg, Lykke Midtbøll, Østergaard, Mikkel, Boyesen, P., Thormann, A., Tarp, U., Bohme, W., Dencker, D., Lindegaard, Hanne Merete, Poulsen, U.E., Hansen, Annette, Ringsdal, V.S., Schlemmer, Annette, Graudal, N., Andersen, Anne, Espesen, J., Kollerup, G., Christensen, T.G., Pelck, R., Glintborg, Bente, Madsen, Ole Rintek, Jensen, Dorte Vendelbo, Majgaard, O., Hetland, Merete Lund, Ørnbjerg, Lykke Midtbøll, Østergaard, Mikkel, Boyesen, P., Thormann, A., Tarp, U., Bohme, W., Dencker, D., Lindegaard, Hanne Merete, Poulsen, U.E., Hansen, Annette, Ringsdal, V.S., Schlemmer, Annette, Graudal, N., Andersen, Anne, Espesen, J., Kollerup, G., Christensen, T.G., Pelck, R., Glintborg, Bente, Madsen, Ole Rintek, Jensen, Dorte Vendelbo, Majgaard, O., and Hetland, Merete Lund

Published
2012

3. Impact of tumour necrosis factor inhibitor treatment on hand bone loss in rheumatoid arthritis patients treated in clinical practice. Results from the nationwide Danish Danbio Registry.

Author

Ørnbjerg, Lykke Midtbøll, Østergaard, Mikkel, Boyesen, P., Jensen, T.D., Thormann, A., Tarp, U., Bohme, W., Dencker, D., Lindegaard, Hanne Merete, Poulsen, U.E., Hansen, Annette, Ringsdal, V.S., Schlemmer, Annette, Graudal, N., Andersen, Anne, Espesen, J., Kollerup, G., Christensen, T.G., Pelck, R., Glintborg, Bente, Madsen, Ole Rintek, Jensen, Dorte Vendelbo, Majgaard, O., Hetland, Merete Lund, Ørnbjerg, Lykke Midtbøll, Østergaard, Mikkel, Boyesen, P., Jensen, T.D., Thormann, A., Tarp, U., Bohme, W., Dencker, D., Lindegaard, Hanne Merete, Poulsen, U.E., Hansen, Annette, Ringsdal, V.S., Schlemmer, Annette, Graudal, N., Andersen, Anne, Espesen, J., Kollerup, G., Christensen, T.G., Pelck, R., Glintborg, Bente, Madsen, Ole Rintek, Jensen, Dorte Vendelbo, Majgaard, O., and Hetland, Merete Lund

Published
2012

4. Does dynamic contrast-enhanced MRI provide better separation of active early rheumatoid arthritis patients and healthy controls than conventional MRI?

Author

Axelsen, Mette Bjørndal, Ejbjerg, B.J., Hetland, Merete Lund, Hørslev-Petersen, Kim, Lauridsen, U.B., Majgaard, O., Boesen, M., Kubassova, O., Bliddal, Henning, Østergaard, Mikkel, Axelsen, Mette Bjørndal, Ejbjerg, B.J., Hetland, Merete Lund, Hørslev-Petersen, Kim, Lauridsen, U.B., Majgaard, O., Boesen, M., Kubassova, O., Bliddal, Henning, and Østergaard, Mikkel

Published
2012

5. Separation of active early rheumatoid arthritis patients and healthy controls by conventional and dynamic contrast-enhanced MRI.

Author

Axelsen, Mette Bjørndal, Ejbjerg, B., Hetland, Merete Lund, Hørslev-Petersen, Kim, Lauridsen, U.B., Majgaard, O., Boesen, M., Kubassova, O., Bliddal, Henning, Østergaard, Mikkel, Axelsen, Mette Bjørndal, Ejbjerg, B., Hetland, Merete Lund, Hørslev-Petersen, Kim, Lauridsen, U.B., Majgaard, O., Boesen, M., Kubassova, O., Bliddal, Henning, and Østergaard, Mikkel

Published
2012

6. Impact of drug discontinuation on radiographic progression 2 years after initiation of TNF-inhibitor treatment in clinical practice.

Author

Ørnbjerg, Lykke Midtbøll, Østergaard, Mikkel, Bøyesen, P., Thormann, A., Tarp, Ulrik, Böhme, Wolfgang, Nielsen, Ditte Dencker, Lindegaard, Hanne Merete, Poulsen, U., Hansen, Annette, Ringsdal, Vibeke Stevenius, Schlemmer, Annette, Graudal, Niels Albert, Andersen, Anne, Espesen, J., Kollerup, G., Christensen, T., Pelck, R., Glintborg, Bente, Madsen, Ole Rintek, Jensen, D., Majgaard, O., Hetland, Merete Lund, Ørnbjerg, Lykke Midtbøll, Østergaard, Mikkel, Bøyesen, P., Thormann, A., Tarp, Ulrik, Böhme, Wolfgang, Nielsen, Ditte Dencker, Lindegaard, Hanne Merete, Poulsen, U., Hansen, Annette, Ringsdal, Vibeke Stevenius, Schlemmer, Annette, Graudal, Niels Albert, Andersen, Anne, Espesen, J., Kollerup, G., Christensen, T., Pelck, R., Glintborg, Bente, Madsen, Ole Rintek, Jensen, D., Majgaard, O., and Hetland, Merete Lund

Published
2010

7. High Sensitive Crp Increases Sensitivity and Responsiveness of Asdas

Author

Pedersen, S.J., Sørensen, Inge Juul, Johansen, J.S., Madsen, O.R., Tvede, N., Hansen, M.S., Thamsborg, G., Andersen, L.S., Majgaard, O., Loft, A.G., Erlendsson, J., Asmussen, K., Jurik, Anne Grethe, Møller, Jakob Møllenbach, Hasselquist, M., Mikkelsen, D., Skjødt, Thea, Hansen, A., Østergaard, Mikkel, Pedersen, S.J., Sørensen, Inge Juul, Johansen, J.S., Madsen, O.R., Tvede, N., Hansen, M.S., Thamsborg, G., Andersen, L.S., Majgaard, O., Loft, A.G., Erlendsson, J., Asmussen, K., Jurik, Anne Grethe, Møller, Jakob Møllenbach, Hasselquist, M., Mikkelsen, D., Skjødt, Thea, Hansen, A., and Østergaard, Mikkel

Published
2010

8. Impact of TNF-inhibitor treatment on radiographic joint destruction in rheumatoid arthritis patients treated in clinical practice.

Author

Ørnbjerg, Lykke Midtbøll, Østergaard, Mikkel, Thormann, Annette Bøeg, Bøyesen, P., Tarp, Ulrik, Böhme, Wolfgang, Nielsen, Ditte Dencker, Lindegaard, Hanne Merete, Poulsen, U., Hansen, Annette, Ringsdal, Vibeke Stevenius, Schlemmer, Annette, Graudal, Niels Albert, Andersen, Anne, Espesen, J., Kollerup, Gina Birgitte, Christensen, T., Pelck, R., Glintborg, Bente, Madsen, Ole Rintek, Jensen, D., Majgaard, O., Hetland, Merete Lund, Ørnbjerg, Lykke Midtbøll, Østergaard, Mikkel, Thormann, Annette Bøeg, Bøyesen, P., Tarp, Ulrik, Böhme, Wolfgang, Nielsen, Ditte Dencker, Lindegaard, Hanne Merete, Poulsen, U., Hansen, Annette, Ringsdal, Vibeke Stevenius, Schlemmer, Annette, Graudal, Niels Albert, Andersen, Anne, Espesen, J., Kollerup, Gina Birgitte, Christensen, T., Pelck, R., Glintborg, Bente, Madsen, Ole Rintek, Jensen, D., Majgaard, O., and Hetland, Merete Lund

Published
2010

9. The ankylosing spondylitis disease activity score (ADAS) better reflects the inflammatory disease processes than BASDAI. - A comparison with biomarkers of inflammation, cartilage and bone turnover in patients with axial spondyloarthritis treated with TNF-blockers.

Author

Pedersen, Susanne Juhl, Sørensen, Inge Juul, Garnero, P., Johansen, Julia Sidenius, Madsen, Ole Rintek, Tvede, Niels, Hansen, Mikael Secher, Thamsborg, Gorm Milan, Andersen, Lasse Darling, Majgaard, O., Loft, Anne Gitte, Erlendsson, J., Asmussen, Karsten Heller, Jurik, Anne Grethe, Møller, Jakob Møllenbach, Hasselquist, Maria, Mikkelsen, Dorte, Skjødt, Thomas, Hansen, Annette, Østergaard, Mikkel, Pedersen, Susanne Juhl, Sørensen, Inge Juul, Garnero, P., Johansen, Julia Sidenius, Madsen, Ole Rintek, Tvede, Niels, Hansen, Mikael Secher, Thamsborg, Gorm Milan, Andersen, Lasse Darling, Majgaard, O., Loft, Anne Gitte, Erlendsson, J., Asmussen, Karsten Heller, Jurik, Anne Grethe, Møller, Jakob Møllenbach, Hasselquist, Maria, Mikkelsen, Dorte, Skjødt, Thomas, Hansen, Annette, and Østergaard, Mikkel

Published
2010

10. Aggressive combination therapy with intra-articular glucocorticoid injections and conventional disease-modifying anti-rheumatic drugs in early rheumatoid arthritis: second-year clinical and radiographic results from the CIMESTRA study

Author

Hetland, M.L., Stengaard-Pedersen, K., Junker, P., Lottenburger, T., Hansen, I., Andersen, L.S., Tarp, U., Svendsen, A., Pedersen, J.K., Skjodt, H., Lauridsen, U.B., Ellingsen, T., Hansen, G.V., Lindegaard, H., Vestergaard, A., Jurik, A.G., Ostergaard, M., Horslev-Petersen, K., Lorenzen, I., Jensen, S.H., Podenphant, J., Bendtsen, H., Faarvang, K.L., Hansen, Michael Sejer, Hansen, Troels Mørk, Nielsen, H., Jacobsen, S., Majgaard, O., Beier, J., Ejstrup, L., Knudsen, J.B., Laustrup, H., Krogh, N.S., Vallø, J., Thomsen, H.S., Ejbjerg, B., Torfing, T., Bukh, G., Frederiksen, J., Rasmussen, P., Theilgard, K., Gerdes, L., Holm, H., Lorentzen, K.B., Pdersen-Zbinden, B., Hetland, M.L., Stengaard-Pedersen, K., Junker, P., Lottenburger, T., Hansen, I., Andersen, L.S., Tarp, U., Svendsen, A., Pedersen, J.K., Skjodt, H., Lauridsen, U.B., Ellingsen, T., Hansen, G.V., Lindegaard, H., Vestergaard, A., Jurik, A.G., Ostergaard, M., Horslev-Petersen, K., Lorenzen, I., Jensen, S.H., Podenphant, J., Bendtsen, H., Faarvang, K.L., Hansen, Michael Sejer, Hansen, Troels Mørk, Nielsen, H., Jacobsen, S., Majgaard, O., Beier, J., Ejstrup, L., Knudsen, J.B., Laustrup, H., Krogh, N.S., Vallø, J., Thomsen, H.S., Ejbjerg, B., Torfing, T., Bukh, G., Frederiksen, J., Rasmussen, P., Theilgard, K., Gerdes, L., Holm, H., Lorentzen, K.B., and Pdersen-Zbinden, B.

Abstract

OBJECTIVE: To investigate whether clinical and radiographic disease control can be achieved and maintained in patients with early, active rheumatoid arthritis (RA) during the second year of aggressive treatment with conventional disease-modifying antirheumatic drugs (DMARDs) and intra-articular corticosteroid. This paper presents the results of the second year of the randomised, controlled double-blind CIMESTRA (Ciclosporine, Methotrexate, Steroid in RA) study. METHODS: 160 patients with early RA (duration <6 months) were randomised to receive intra-articular betamethasone in any swollen joint in combination with step-up treatment with either methotrexate and placebo-ciclosporine (monotherapy) or methotrexate plus ciclosporine (combination therapy) during the first 76 weeks. At week 68 hydroxychlorochine 200 mg daily was added. From week 76-104 ciclosporine/placebo-ciclosporine was tapered to zero. RESULTS: American College of Rheumatology 20% improvement (ACR20), ACR50 and ACR70 levels were achieved in 88%, 79% and 59% of patients in the combination vs 72%, 62% and 54% in the monotherapy group (p = 0.03, 0.02 and 0.6 between groups). The patients globally declined from 50 to 12 vs 52 to 9, with 51% and 50% in Disease Activity Score (DAS) remission, respectively. Mean (SD) progressions in total Sharp-van der Heijde scores were 1.42 (3.52) and 2.03 (5.86) in combination and monotherapy groups, respectively (not significant). Serum creatinine levels increased by 7% in the combination group (4% in monotherapy), but hypertension was not more prevalent. CONCLUSION: Continuous methotrexate and intra-articular corticosteroid treatment resulted in excellent clinical response and disease control at 2 years, and the radiographic erosive progression was minimal. Addition of ciclosporine during the first 76 weeks resulted in significantly better ACR20 and ACR50 responses, but did not have any additional effect on remission rate and radiographic outcome Udgivelsesdato

Published
2008

11. MRI assessment of sacroiliac joint inflammation and destruction and Spine inflammation during Anti-TNF-Alpha therapy - An investigator initiated 1-year follow-up study of patients with axial spondyloarthritis

Author

Pedersen, S.J., Hermann, K.G., Sorensen, I.J., Madsen, Ole Rintek, Andersen, L.S., Loft, A.G., Erlendsson, J., Asmussen, K., Moller, J., Hasselquist, M., Ostergaard, M., Tvede, N., Hansen, M.S., Thamsborg, G., Majgaard, O., Hensen, A., Jurik, A.G., Skjodt, T., Mikkelsen, D., Pedersen, S.J., Hermann, K.G., Sorensen, I.J., Madsen, Ole Rintek, Andersen, L.S., Loft, A.G., Erlendsson, J., Asmussen, K., Moller, J., Hasselquist, M., Ostergaard, M., Tvede, N., Hansen, M.S., Thamsborg, G., Majgaard, O., Hensen, A., Jurik, A.G., Skjodt, T., and Mikkelsen, D.

Abstract

Udgivelsesdato: 2008/9

Published
2008

12. Circulating levels of plasma IL-6, VEGF, YKL-40, and COMP in spondyloarthritis patients during anti-TNF alpha treatment

Author

Pedersen, S.J., Sorensen, I.J., Johansen, J.S., Madsen, Ole Rintek, Tvede, N., Hansen, M.S., Thamsborg, G., Andersen, L.S., Majgaard, O., Loft, A.G., Erlendsson, J., Asmussen, K., Hansen, A., Ostergaard, M., Pedersen, S.J., Sorensen, I.J., Johansen, J.S., Madsen, Ole Rintek, Tvede, N., Hansen, M.S., Thamsborg, G., Andersen, L.S., Majgaard, O., Loft, A.G., Erlendsson, J., Asmussen, K., Hansen, A., and Ostergaard, M.

Abstract

Udgivelsesdato: 2008

Published
2008

13. MRI bone oedema is the strongest predictor of subsequent radiographic progression in early rheumatoid arthritis. Results from a 2 year randomized controlled trial (CIMESTRA)

Author

Hetland, M L, Ejbjerg, B, Hørslev-Petersen, K, Jacobsen, S, Vestergaard, A, Jurik, A G, Stengaard-Pedersen, K, Junker, P, Lottenburger, T, Hansen, I, Andersen, L S, Tarp, U, Skjødt, H, Pedersen, J K, Majgaard, O, Svendsen, A J, Ellingsen, T, Lindegaard, H, Christensen, A F, Vallø, J, Torfing, T, Narvestad, E, Thomsen, H S, Ostergaard, M, Hetland, Merete Lund, Ejbjerg, Bo Jannik, Hørslev-Petersen, Kim, Jacobsen, Søren, Vestergaard, Aage, Jurik, Anne Grethe, Stengaard-Pedersen, Kristian, Junker, Peter, Lottenburger, Tine, Hansen, Ib, Andersen, Lis Smedegaard, Tarp, Ulrik, Skjødt, Henrik, Pedersen, Jens K, Majgaard, Ole, Svendsen, Anders J, Ellingsen, Torkell, Lindegaard, Hanne M, Christensen, Anne F, Vallø, Jørgen, Torfing, Trine, Narvestad, Eva, Thomsen, Henrik S, Ostergaard, Mikkel, Hetland, M L, Ejbjerg, B, Hørslev-Petersen, K, Jacobsen, S, Vestergaard, A, Jurik, A G, Stengaard-Pedersen, K, Junker, P, Lottenburger, T, Hansen, I, Andersen, L S, Tarp, U, Skjødt, H, Pedersen, J K, Majgaard, O, Svendsen, A J, Ellingsen, T, Lindegaard, H, Christensen, A F, Vallø, J, Torfing, T, Narvestad, E, Thomsen, H S, Ostergaard, M, Hetland, Merete Lund, Ejbjerg, Bo Jannik, Hørslev-Petersen, Kim, Jacobsen, Søren, Vestergaard, Aage, Jurik, Anne Grethe, Stengaard-Pedersen, Kristian, Junker, Peter, Lottenburger, Tine, Hansen, Ib, Andersen, Lis Smedegaard, Tarp, Ulrik, Skjødt, Henrik, Pedersen, Jens K, Majgaard, Ole, Svendsen, Anders J, Ellingsen, Torkell, Lindegaard, Hanne M, Christensen, Anne F, Vallø, Jørgen, Torfing, Trine, Narvestad, Eva, Thomsen, Henrik S, and Ostergaard, Mikkel

Abstract

OBJECTIVE: To identify predictors of radiographic progression in a 2-year randomized, double-blind clinical study (CIMESTRA) of patients with early rheumatoid arthritis (RA). METHODS: Early RA patients (N=130) were treated with methotrexate, intra-articular betamethasone and cyclosporine/placebo-cyclosporine. Baseline magnetic resonance imaging (MRI) of the wrist (wrist-only-group:N=130) or MRI of wrist and MCP-joints (wrist+MCP-group:N=89) (OMERACT RAMRIS), x-rays of hands, wrists and forefeet (Sharp/vdHeijde Score (TSS)), disease activity score (DAS28), anti-cyclic-citrullinated-peptide-antibodies (anti-CCP), HLA-DRB1-shared-epitope (SE) and smoking status were assessed. Multiple regression analysis was performed with delta-TSS (0-2 years) as dependent variable, and baseline DAS28, TSS, MRI bone oedema score, MRI synovitis score, MRI erosion score, anti-CCP, smoking, SE, age and gender as explanatory variables. RESULTS: Baseline values: median DAS28: 5.6 (range: 2.4-8.0); anti-CCP positive: 61%; radiographic erosions: 56%. At 2 years: DAS28: 2.0 (0.5-5.7), in DAS-remission: 56%, radiographic progression: 26% (wrist+MCP-group, similar for wrist-only-group). MRI bone oedema score was the only independent predictor of delta-TSS (wrist+MCP-group: coefficient=0.75 (95%CI: 0.56-0.97), p<0.00001; wrist-only-group: coefficient=0.56 (0.41-0.77), p<0.00001). Bone oedema score explained 41% of the variation in the progression of TSS (wrist+MCP-group), 25% in wrist-only-group, (Pearson's r=0.64 and r=0.50, respectively). The results were confirmed by sensitivity analyses. CONCLUSION: In a RCT aiming at remission in early RA patients, baseline RAMRIS MRI bone oedema score of MCP and wrist joints (and of wrist only) was the strongest independent predictor of radiographic progression in hands, wrists and forefeet after 2 years. MRI synovitis score, MRI erosion score, DAS28, anti-CCP, SE, smoking, age and gender were not independent risk factors Udgivelsesdato: 2008/4, OBJECTIVE: To identify predictors of radiographic progression in a 2-year randomized, double-blind clinical study (CIMESTRA) of patients with early rheumatoid arthritis (RA). METHODS: Early RA patients (N=130) were treated with methotrexate, intra-articular betamethasone and cyclosporine/placebo-cyclosporine. Baseline magnetic resonance imaging (MRI) of the wrist (wrist-only-group:N=130) or MRI of wrist and MCP-joints (wrist+MCP-group:N=89) (OMERACT RAMRIS), x-rays of hands, wrists and forefeet (Sharp/vdHeijde Score (TSS)), disease activity score (DAS28), anti-cyclic-citrullinated-peptide-antibodies (anti-CCP), HLA-DRB1-shared-epitope (SE) and smoking status were assessed. Multiple regression analysis was performed with delta-TSS (0-2 years) as dependent variable, and baseline DAS28, TSS, MRI bone oedema score, MRI synovitis score, MRI erosion score, anti-CCP, smoking, SE, age and gender as explanatory variables. RESULTS: Baseline values: median DAS28: 5.6 (range: 2.4-8.0); anti-CCP positive: 61%; radiographic erosions: 56%. At 2 years: DAS28: 2.0 (0.5-5.7), in DAS-remission: 56%, radiographic progression: 26% (wrist+MCP-group, similar for wrist-only-group). MRI bone oedema score was the only independent predictor of delta-TSS (wrist+MCP-group: coefficient=0.75 (95%CI: 0.56-0.97), p<0.00001; wrist-only-group: coefficient=0.56 (0.41-0.77), p<0.00001). Bone oedema score explained 41% of the variation in the progression of TSS (wrist+MCP-group), 25% in wrist-only-group, (Pearson's r=0.64 and r=0.50, respectively). The results were confirmed by sensitivity analyses. CONCLUSION: In a RCT aiming at remission in early RA patients, baseline RAMRIS MRI bone oedema score of MCP and wrist joints (and of wrist only) was the strongest independent predictor of radiographic progression in hands, wrists and forefeet after 2 years. MRI synovitis score, MRI erosion score, DAS28, anti-CCP, SE, smoking, age and gender were not independent risk factors.

Published
2008

14. Aggressive non-biologic therapy eliminates radiographic progression in early rheumatoid arthritis – results from a randomised controlled trial of methotrexate, intraarticular steroid and cyclosporine/placebo (CIMESTRA).

Author

Hørslev-Petersen, K, Østergaard, Mikkel, Carvalho, A, Stengaard-Pedersen, K, Junker, P, Lottenburger, T, Hansen, I, Andersen, L.S., Tarp, U, Skjødt, H, Pedersen, J.K., Majgaard, O, Svendsen, A, Ellingsen, T, Pødenphant, J, Hansen, G, Lindegaard, H, Hetland, M.L., Hørslev-Petersen, K, Østergaard, Mikkel, Carvalho, A, Stengaard-Pedersen, K, Junker, P, Lottenburger, T, Hansen, I, Andersen, L.S., Tarp, U, Skjødt, H, Pedersen, J.K., Majgaard, O, Svendsen, A, Ellingsen, T, Pødenphant, J, Hansen, G, Lindegaard, H, and Hetland, M.L.

Published
2004

15. Radiographic progression is associated with resolution of systemic inflammation in patients with axial spondylarthritis treated with tumor necrosis factor α inhibitors: a study of radiographic progression, inflammation on magnetic resonance imaging, and circulating biomarkers of inflammation, angiogenesis, and cartilage and bone turnover.

Author

Pedersen SJ, Sørensen IJ, Lambert RG, Hermann KG, Garnero P, Johansen JS, Madsen OR, Hansen A, Hansen MS, Thamsborg G, Andersen LS, Majgaard O, Loft AG, Erlendsson J, Asmussen KH, Jurik AG, Møller J, Hasselquist M, Mikkelsen D, and Østergaard M

Subjects
Adalimumab, Adult, Antibodies, Monoclonal therapeutic use, Antibodies, Monoclonal, Humanized therapeutic use, Biomarkers blood, C-Reactive Protein metabolism, Cartilage Oligomeric Matrix Protein, Case-Control Studies, Cohort Studies, Extracellular Matrix Proteins blood, Female, Glycoproteins blood, Humans, Infliximab, Interleukin-6 blood, Magnetic Resonance Imaging, Male, Matrilin Proteins, Matrix Metalloproteinase 3 blood, Middle Aged, Osteocalcin blood, Prospective Studies, Radiography, Spondylarthritis blood, Vascular Endothelial Growth Factor A blood, Bone and Bones metabolism, Cartilage metabolism, Disease Progression, Inflammation diagnostic imaging, Inflammation pathology, Neovascularization, Pathologic blood, Spondylarthritis drug therapy, Tumor Necrosis Factor-alpha antagonists & inhibitors
Abstract

Objective: To investigate the relationship of circulating biomarkers of inflammation (C-reactive protein [CRP], interleukin-6 [IL-6], and YKL-40), angiogenesis (vascular endothelial growth factor), cartilage turnover (C-terminal crosslinking telopeptide of type II collagen [CTX-II], total aggrecan, matrix metalloproteinase 3 [MMP-3], and cartilage oligomeric matrix protein [COMP]), and bone turnover (CTX-I and osteocalcin) to inflammation on magnetic resonance imaging (MRI) and radiographic progression in patients with axial spondylarthritis (SpA) beginning tumor necrosis factor α (TNFα) inhibitor therapy., Methods: MRIs were evaluated according to the Berlin sacroiliac (SI) joint and spine inflammation scoring method at baseline, week 22, and week 46. Radiographs were evaluated using the modified Stoke Ankylosing Spondylitis Spine Score at baseline and week 46. Patients with new syndesmophytes were identified. Biomarker levels in patients were compared to levels in healthy subjects., Results: Higher pretreatment MRI inflammation scores for SI joints and/or lumbar spine were associated with higher baseline CTX-II levels, but not with higher levels of biomarkers of inflammation and bone turnover. During treatment with TNFα inhibitors, a decrease in MRI inflammation scores from baseline to week 22 was associated with larger percentage decreases in and a normalization of CRP and IL-6 levels as compared to an increase or no change in MRI scores. Development of new syndesmophytes was associated with larger percentage decreases in CRP and IL-6 levels and an increase in osteocalcin level, and with normalization of CRP and IL-6 levels from baseline to week 22. Persistent systemic inflammation was associated with radiographic nonprogression., Conclusion: Our findings indicate that inflammation on baseline MRI is associated with higher CTX-II levels. Radiographic progression is associated with decreased systemic inflammation, as assessed by IL-6 and CRP levels and MRI, supporting the notion of a link between the resolution of inflammation and new bone formation in SpA patients during anti-TNFα therapy., (Copyright © 2011 by the American College of Rheumatology.)

Published
2011
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