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Radiographic remission in rheumatoid arthritis quantified by computer-aided joint space analysis (CASJA): a post hoc analysis of the RAPID 1 trial

Authors
  • Pfeil, Alexander1
  • Nussbaum, Anica1
  • Renz, Diane M.2
  • Hoffmann, Tobias1
  • Malich, Ansgar3
  • Franz, Marcus1
  • Oelzner, Peter1
  • Wolf, Gunter1
  • Böttcher, Joachim4, 4
  • 1 Jena University Hospital – Friedrich Schiller University Jena, Am Klinikum 1, Jena, 07747, Germany , Jena (Germany)
  • 2 Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany , Hannover (Germany)
  • 3 Suedharz-Hospital Nordhausen, Dr. Robert-Koch-Straße 38, Nordhausen, 99734, Germany , Nordhausen (Germany)
  • 4 University Jena, Am Klinikum 1, Jena, 07747, Germany , Jena (Germany)
Type
Published Article
Journal
Arthritis Research & Therapy
Publisher
Springer Science and Business Media LLC
Publication Date
Oct 06, 2020
Volume
22
Issue
1
Identifiers
DOI: 10.1186/s13075-020-02322-9
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundThe reduction of finger joint space width (JSW) in patients with rheumatoid arthritis (RA) is strongly associated with joint destruction. Treatment with certolizumab pegol (CZP), a PEGylated anti-TNF, has been proven to be effective in RA patients. The computer-aided joint space analysis (CAJSA) provides the semiautomated measurement of joint space width at the metacarpal-phalangeal joints (MCP) based on hand radiographs. The aim of this post hoc analysis of the RAPID 1 trial was to quantify MCP joint space distance (JSD-MCP) measured by CAJSA between baseline and week 52 in RA patients treated with certolizumab pegol (CZP) plus methotrexate (MTX) compared with MTX/placebo.MethodsThree hundred twenty-eight patients were included in the post hoc analysis and received placebo plus MTX, CZP 200 mg plus MTX and CZP 400 mg plus MTX. All patients underwent X-rays of the hand at baseline and week 52 as well as assessment of finger joint space narrowing of the MCP using CAJSA (Version 1.3.6; Sectra; Sweden). The joint space width (JSW) was expressed as mean joint space distance of the MCP joints I to V (JSD-MCPtotal).ResultsThe MTX group showed a significant reduction of joint space of − 4.8% (JSD-MCPtotal), whereas in patients treated with CZP 200 mg/MTX and CZP 400 mg/MTX a non-significant change (JSD-MCPtotal + 0.6%) was observed. Over 52 weeks, participants with DAS28 remission (DAS28 ≤ 2.6) exhibited a significant joint space increase of + 3.3% (CZP 200 mg plus MTX) and + 3.9% (CZP pegol 400 mg plus MTX).ConclusionCZP plus MTX did not reduce JSD-MCPtotal estimated by CAJSA compared with MTX/placebo. Furthermore, clinical remission (DAS28 ≤ 2.6) in patients treated with CZP plus MTX was associated with an increasing JSD, indicating radiographic remission in RA.

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