TY - JOUR
T1 - Knee cartilage quality assessed with dGEMRIC in rheumatoid arthritis patients before and after treatment with a TNF inhibitor.
AU - Tiderius, Carl Johan
AU - Sandin, Joakim
AU - Svensson, Jonas
AU - Dahlberg, Leif
AU - Jacobsson, Lennart
PY - 2010
Y1 - 2010
N2 - 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.
AB - 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.
U2 - 10.3109/02841851.2010.510482
DO - 10.3109/02841851.2010.510482
M3 - Article
C2 - 20942734
SN - 1600-0455
VL - 51
SP - 1034
EP - 1037
JO - Acta radiologica (Stockholm, Sweden : 1987)
JF - Acta radiologica (Stockholm, Sweden : 1987)
IS - 9
ER -