OP0331 MAGNETIC RESONANCE IMAGING TENOSYNOVITIS AND OSTEITIS ARE INDEPENDENT PREDICTORS OF RADIOGRAPHIC AND MRI DAMAGE PROGRESSION IN RHEUMATOID ARTHRITIS PATIENTS IN CLINICAL REMISSION

Signe Møller-Bisgaard,Ellen Margrethe Hauge,Karsten Asmussen,Henning Bliddal,Oliver Hendricks,Daniel Glinatsi,Mikael Boesen,Niels Steen Krogh,Bo Ejbjerg,Torkell Ellingsen,Anne Grethe Jurik,Lone Balding,Marcin Kowalski,Ole Rintek Madsen ,Merete Lund Hetland ,Henrik S Thomsen ,Jakob Møllenbach Møller ,Kristian Stengaard–Pedersen ,Kim Hørslev‐Petersen ,Hanne Lindegaard ,Lykke Midtbøll Ørnbjerg ,Jan Alexander Villadsen ,Philip C Bennett ,A Nielsen ,Bo Jensen ,Mikkel Østergaard

doi:10.1136/annrheumdis-2019-eular.2006

Abstract

Background Progression of structural joint damage occurs in 20-30 % of patients with rheumatoid arthritis (RA) in clinical remission1. Magnetic resonance imaging (MRI)-detected synovitis and in particular osteitis/bone marrow edema (BME) are known predictors of structural progression in both active RA and in remission, but the predictive value of adding MRI tenosynovitis assessment as potential predictor in patients in clinical remission has not been investigated. Objectives To investigate the predictive value of baseline MRI inflammatory and damage parameters on 2 year MRI and X-ray damage progression in an RA cohort in clinical remission, following MRI and conventional treat-to-target (T2T) strategies. Methods 200 RA patients in clinical remission (DAS28-CRP The following potentially predictive baseline variables: MRI BME, synovitis, tenosynovitis, MRI and X-ray erosion and joint space narrowing (JSN) score, CRP, DAS28, smoking status, gender, age and patient group were tested in univariate logistic regression analyses with 2-year progression in MRI combined damage score, Total Sharp Score (TSS), and MRI and X-ray JSN and erosion scores as dependent variables. Variables with p Results Based on univariate analyses MRI BME, synovitis, tenosynovitis, x-ray erosion and JSN, gender and age were included in subsequent multivariable analyses. Independent MRI predictors of structural progression were BME (MRI progression) and tenosynovitis (MRI and X-ray progression), see table. MRI combined damage score: sum score of MRI erosion and JSN scores. Conclusion This trial is the first to report that MRI tenosynovitis independently predicts both X-ray and MRI damage progression in RA patients in clinical remission. Further studies are needed to confirm MRI-determined tenosynovitis as predictor of progressive joint destruction in RA clinical remission.

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