Multimodal imaging of structural damage and inflammation in psoriatic arthritis: a comparison of DMARD-naive and DMARD-failure patients.

IF 4.7 2区医学 Q1 RHEUMATOLOGY

Rheumatology Pub Date : 2025-04-01 DOI:10.1093/rheumatology/keae450

Nağme Ö Renkli, Nienke J Kleinrensink, Julia Spierings, Simon Mastbergen, Harald E Vonkeman, Shasti C Mooij, Lydia G Schipper, Amin Herman, Iris Ten Katen, Frank J Nap, Marjolein E Hol, Pim A de Jong, Mylène P Jansen, Wouter Foppen

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引用次数: 0

Abstract

Objectives: To compare inflammatory and structural differences in active PsA between DMARD-naive and DMARD-failure patients using diverse imaging approaches for future analyses. Additionally, to explore the influence of patient characteristics (clinical and demographic variables) on imaging findings.

Methods: Of the 80 patients included from the first cohort of the ongoing multicentre TOFA-PREDICT trial, 40 were DMARD-naive and 40 were DMARD-failure (csDMARD failure; one prior bDMARD excluding etanercept was allowed), all meeting classification criteria for PsA with a minimum disease duration of eight weeks. Baseline conventional radiographs of hands and feet, MRIs of both ankles, and whole-body [18F]-fluorodeoxyglucose PET/CT (18F-FDG PET/CT) were evaluated for inflammatory and structural imaging parameters, including Sharp-van der Heijde (SHS), Heel Enthesitis Magnetic Resonance Imaging Scoring System (HEMRIS) and Deauville synovitis scoring. Differences between groups and the influence of patient characteristics were examined with multiple linear regression.

Results: At baseline, patient characteristics were similar between groups. Imaging parameters showed limited inflammation and structural damage. Inflammatory imaging parameters were not significantly different (P > 0.200). Among structural parameters, only HEMRIS Achilles tendon structural damage was significantly different (P = 0.024, R2 = 0.071) and SHS Joint Space Narrowing was not statistically significant (P = 0.050, R2 = 0.048) with higher values for both in DMARD failures. After correction of patient characteristics, these differences in imaging disappeared (both P > 0.600).

Conclusion: At baseline, PsA patient groups were comparable concerning structural and inflammatory imaging parameters, especially after correcting for patient characteristics. Thus, DMARD-naive and DMARD-failure patient groups may be combined in future PsA progression and treatment decision studies.

Trial registration: www.clinicaltrialsregister.eu. EudraCT: 2017-003900-28.

查看原文本刊更多论文

银屑病关节炎结构损伤和炎症的多模态成像：DMARD无效患者与DMARD无效患者的比较。

目的：使用不同的影像学方法，比较未使用改良抗风湿药（DMARD）和使用改良抗风湿药失败的活动性银屑病关节炎（PsA）患者的炎症和结构差异，以便将来进行分析。此外，探讨患者特征（临床和人口统计学变量）对成像结果的影响：目前正在进行的TOFA-PREDICT多中心试验的第一批80名患者中，40名是DMARD无效患者，40名是DMARD失败患者（csDMARD失败；允许既往使用过1种bDMARD，但不包括etanercept），所有患者均符合PsA分类标准，病程至少8周。对基线手足常规X光片、双足踝核磁共振成像和全身18F-FDG PET/CT进行了炎症和结构成像参数评估，包括夏普-范德海德（SHS）、足跟腱膜炎核磁共振成像评分系统（HEMRIS）和多维尔滑膜炎评分。通过多元线性回归研究了组间差异和患者特征的影响：各组患者的基线特征相似。成像参数显示炎症和结构损伤有限。炎症成像参数无明显差异（P> 0.200）。在结构参数中，只有HEMRIS跟腱结构损伤有显著差异（p= 0.024，R2=0.071），而SHS关节间隙狭窄无统计学意义（p= 0.050，R2=0.048），DMARD失败患者的这两项参数值均较高。在对患者特征进行校正后，这些影像学差异消失了（P均> 0.600）：结论：基线时，PsA 患者组在结构和炎症成像参数方面具有可比性，尤其是在校正患者特征后。因此，在未来的PsA进展和治疗决策研究中，可将DMARD无效患者组和DMARD失败患者组结合起来：EudraCT：2017-003900-28。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Rheumatology 医学-风湿病学

CiteScore

9.40

自引率

7.30%

发文量

1091

审稿时长

2 months

期刊介绍： Rheumatology strives to support research and discovery by publishing the highest quality original scientific papers with a focus on basic, clinical and translational research. The journal’s subject areas cover a wide range of paediatric and adult rheumatological conditions from an international perspective. It is an official journal of the British Society for Rheumatology, published by Oxford University Press. Rheumatology publishes original articles, reviews, editorials, guidelines, concise reports, meta-analyses, original case reports, clinical vignettes, letters and matters arising from published material. The journal takes pride in serving the global rheumatology community, with a focus on high societal impact in the form of podcasts, videos and extended social media presence, and utilizing metrics such as Altmetric. Keep up to date by following the journal on Twitter @RheumJnl.