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Knee cartilage quality assessed with dGEMRIC in rheumatoid arthritis patients before and after treatment with a TNF inhibitor.

Tiderius, Carl Johan LU ; Sandin, Joakim; Svensson, Jonas LU ; Dahlberg, Leif LU and Jacobsson, Lennart LU (2010) In Acta radiologica (Stockholm, Sweden : 1987) 51(9). p.1034-1037
Abstract
BACKGROUND: TNF-α inhibitors are potent anti-inflammatory drugs that have revolutionized the treatment of rheumatoid arthritis (RA). Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) is a non-invasive method to study cartilage quality, in particular the glycosaminoglycan (GAG) content. PURPOSE: To evaluate knee cartilage quality before and after treatment with a TNF-α inhibitor (infliximab) in patients with RA using dGEMRIC and to study clinical parameters and serum cartilage oligomeric protein (COMP) after the same treatment. MATERIAL AND METHODS: Seven patients with chronic RA received infusions of 3 mg/kg infliximab at weeks 0, 2, 6, 14, and 22. Clinical examination, serum COMP level, and dGEMRIC scans (1.5 T) were performed at... (More)
BACKGROUND: TNF-α inhibitors are potent anti-inflammatory drugs that have revolutionized the treatment of rheumatoid arthritis (RA). Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) is a non-invasive method to study cartilage quality, in particular the glycosaminoglycan (GAG) content. PURPOSE: To evaluate knee cartilage quality before and after treatment with a TNF-α inhibitor (infliximab) in patients with RA using dGEMRIC and to study clinical parameters and serum cartilage oligomeric protein (COMP) after the same treatment. MATERIAL AND METHODS: Seven patients with chronic RA received infusions of 3 mg/kg infliximab at weeks 0, 2, 6, 14, and 22. Clinical examination, serum COMP level, and dGEMRIC scans (1.5 T) were performed at baseline and after 7 months. The dGEMRIC index (ms), reflecting cartilage GAG content, was calculated using an inversion recovery sequence in the femoral weight-bearing cartilage. Seven years after treatment, charts were reviewed regarding joint replacement surgery (TKA). RESULTS: Clinical parameters showed an improvement for all patients after the 7-month treatment period. Serum COMP decreased from 13±4.5 to 11±3.4 (μg, mean ± SD) μg/ml (P<0.05). The dGEMRIC index was lower at follow-up than at baseline, 332±85 and 382±69 (ms, mean ± SD), respectively (P<0.05), indicating loss of GAG. The two patients with the lowest dGEMRIC index had received a TKA 7 years after treatment. CONCLUSION: This longitudinal study indicates a substantial GAG loss from the knee cartilage matrix in patients with chronic RA. Treatment with infliximab does not seem to protect the cartilage from further deterioration despite improvements in clinical parameters and decreased serum COMP. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta radiologica (Stockholm, Sweden : 1987)
volume
51
issue
9
pages
1034 - 1037
publisher
John Wiley & Sons
external identifiers
  • WOS:000283058900013
  • PMID:20942734
  • Scopus:77958066701
ISSN
1600-0455
DOI
10.3109/02841851.2010.510482
language
English
LU publication?
yes
id
3e283b57-e614-4f30-897c-860ab74ee3a9 (old id 1711246)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20942734?dopt=Abstract
date added to LUP
2010-11-05 16:09:49
date last changed
2017-01-01 07:42:25
@article{3e283b57-e614-4f30-897c-860ab74ee3a9,
  abstract     = {BACKGROUND: TNF-α inhibitors are potent anti-inflammatory drugs that have revolutionized the treatment of rheumatoid arthritis (RA). Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) is a non-invasive method to study cartilage quality, in particular the glycosaminoglycan (GAG) content. PURPOSE: To evaluate knee cartilage quality before and after treatment with a TNF-α inhibitor (infliximab) in patients with RA using dGEMRIC and to study clinical parameters and serum cartilage oligomeric protein (COMP) after the same treatment. MATERIAL AND METHODS: Seven patients with chronic RA received infusions of 3 mg/kg infliximab at weeks 0, 2, 6, 14, and 22. Clinical examination, serum COMP level, and dGEMRIC scans (1.5 T) were performed at baseline and after 7 months. The dGEMRIC index (ms), reflecting cartilage GAG content, was calculated using an inversion recovery sequence in the femoral weight-bearing cartilage. Seven years after treatment, charts were reviewed regarding joint replacement surgery (TKA). RESULTS: Clinical parameters showed an improvement for all patients after the 7-month treatment period. Serum COMP decreased from 13±4.5 to 11±3.4 (μg, mean ± SD) μg/ml (P&lt;0.05). The dGEMRIC index was lower at follow-up than at baseline, 332±85 and 382±69 (ms, mean ± SD), respectively (P&lt;0.05), indicating loss of GAG. The two patients with the lowest dGEMRIC index had received a TKA 7 years after treatment. CONCLUSION: This longitudinal study indicates a substantial GAG loss from the knee cartilage matrix in patients with chronic RA. Treatment with infliximab does not seem to protect the cartilage from further deterioration despite improvements in clinical parameters and decreased serum COMP.},
  author       = {Tiderius, Carl Johan and Sandin, Joakim and Svensson, Jonas and Dahlberg, Leif and Jacobsson, Lennart},
  issn         = {1600-0455},
  language     = {eng},
  number       = {9},
  pages        = {1034--1037},
  publisher    = {John Wiley & Sons},
  series       = {Acta radiologica (Stockholm, Sweden : 1987)},
  title        = {Knee cartilage quality assessed with dGEMRIC in rheumatoid arthritis patients before and after treatment with a TNF inhibitor.},
  url          = {http://dx.doi.org/10.3109/02841851.2010.510482},
  volume       = {51},
  year         = {2010},
}