Long-Term efficacy of a 2-year MRI treat-To-Target strategy on disease activity and radiographic progression in patients with rheumatoid arthritis in clinical remission: 5-year follow-up of the IMAGINE-RA randomised trial

Signe Møller-Bisgaard*, Kim Hørslev-Petersen, Lykke Midtbøll Ørnbjerg, Bo Ejbjerg, Merete Lund Hetland, Jakob Møllenbach Møller, Sabrina Mai Nielsen, Daniel Glinatsi, Mikael Boesen, Kristian Stengaard-Pedersen, Ole Rintek Madsen, Bente Jensen, Jan Alexander Villadsen, Ellen Margrethe Hauge, Oliver Hendricks, Hanne Lindegaard, Niels Steen Krogh, Anne Grethe Jurik, Henrik Thomsen, Robin ChristensenMikkel Østergaard

*Corresponding author for this work

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Abstract

Objective To investigate whether a 2-year MRI treat-To-Target strategy targeting the absence of osteitis combined with clinical remission, compared with a conventional treat-To-Target strategy targeting clinical remission only (IMAGINE-rheumatoid arthritis (RA) trial) improves clinical and radiographic outcomes over 5 years in patients with RA in clinical remission. Methods IMAGINE-more was an observational extension study of the original 2-year IMAGINE-RA randomised trial (NCT01656278). Clinical examinations and radiographs (hands and feet) were obtained yearly. Prespecified coprimary outcomes at year 5 were Disease Activity Score in 28 joints C reactive protein (DAS28-CRP) remission rate (DAS28-CRP<2.6) and no radiographic progression (van der Heijde-modified Sharp score (vdHSS) ≤0) from baseline. Secondary outcomes included 5-year changes in radiographic, MRI and clinical measures of disease activity and physical function. Results In total 131 patients, 86 women (67%), mean age 61.2, disease duration 9.5 years, median baseline DAS28-CRP 1.9 (IQR 1.6-2.2) and vdHSS 16.0 (IQR 7.0-36.0) were included in the study; 59 (59%) patients from the original MRI treat-To-Target group and 72 (72%) from the conventional group. At year 5, 47 patients (80%) in the MRI treat-To-Target group vs 54 patients (75%) in the conventional treat-To-Target group were in DAS28-CRP remission (OR 2.00 (95% CI 0.76 to 5.28); p=0.16) while 14 patients (24%) vs 19 patients (26%) had no radiographic progression (OR 0.70, (95% CI 0.28 to 1.71); p=0.43). Conclusion A 2-year combined MRI and clinical treat-To-Target strategy, compared with a conventional clinical treat-To-Target strategy alone, had no effect on the long-Term probability of achieving DAS28-CRP remission and of avoiding radiographic progression.

Original languageEnglish
Article numbere003945
JournalRMD Open
Volume10
Issue number1
ISSN2056-5933
DOIs
Publication statusPublished - 15. Mar 2024

Keywords

  • Arthritis, Rheumatoid
  • Inflammation
  • Magnetic Resonance Imaging
  • Patient Reported Outcome Measures
  • Follow-Up Studies
  • C-Reactive Protein
  • Humans
  • Middle Aged
  • Female
  • Antirheumatic Agents/therapeutic use
  • Arthritis, Rheumatoid/diagnostic imaging
  • Disease Progression

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