MRI Successfully Gauges RA Treatment Response

Peterfy C, Emery P, Tak PP, et al.MRI assessment of suppression of structural damage in patients with rheumatoid arthritis receiving rituximab: results from the randomized, placebo-controlled, double-blind RA-SCORE study. Ann Rheum Dis. 2014: doi:10.1136/annrheumdis-2014-206015.

MRI may finally be coming into its own for the evaluation of cartilage loss in rheumatoid arthritis (RA). The modality shows rituximab's success in significantly reducing erosion and cartilage loss in RA patients who don't do well on methotrextrate.

This study is the first to demonstrate MRI's ability to reveal cartilage loss, and may give the modality an edge over x-ray in clinical trials for RA treatment response assessment, the authors explain.

MRI allows for direct evaluation of cartilage loss, whereas radiography evaluates cartilage loss indirectly by looking at joint space narrowing, they explain.

They randomized patients to two infusions with rituximab (500 mg or 1,000 mg) or placebo. The patient's affected hand and wrist underwent MRI evaluation at multiple time points.

The authors report that patients assigned to either the 1,000-mg or 500-mg dose have significantly better RAMRIS (Outcome Measures in Rheumatology Clinical Trials RA MRI Scoring) erosion scores versus placebo patients.

MRI proves itself as a valuable tool “for assessing inflammatory and structural damage in patients with established rheumatoid arthritis receiving rituximab,” the authors state.

Their conclusion jibes with recommendations from rheumatology societies that support the use of MRI for detecting joint inflammation and assessing treatment response.