RESEARCH - Effect of Humira on joint disease features of patients with PsA detected by MRI

February 10, 2009

Ann Rheum Dis. Published Online First: 9 February 2009.

doi:10.1136/ard.2008.100149

Rheumatism

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Concise Report

Effect of adalimumab on joint disease features of patients with

psoriatic arthritis detected by Magnetic Resonance Imaging

A P Anandarajah 1*, P Ory 2, D Salonen 3, C Feng 1, R L Wong 4 and C T

Ritchlin 1

1 University of Rochester Medical Center, New York, United States

2 University of Washington, Seattle, WA, United States

3 University of Toronto, Toronto, Canada

4 Abbott Pharmaceuticals, United States

Abstract

Background: Joint destruction occurs frequently in patients with

psoriatic arthritis (PsA). In addition to providing insight into

pathogenesis, bone marrow oedema (BMO), synovitis, effusion, and joint

erosion may be used as outcome measures in PsA.

Objective: To assess the impact of adalimumab on BMO, synovitis,

effusion and erosions in PsA, as measured by magnetic resonance

imaging (MRI).

Methods: Fifteen patients with active PsA (3 tender and 3 swollen

joints) were enrolled in an open-label pilot study. Each received

adalimumab subcutaneously every other week for 24 weeks.

Gadolinium-enhanced MR images were obtained at baseline and 24 weeks.

Results: MR images were available for 11 patients, pre- and

post-therapy. BMO and effusion scores improved markedly after 24 weeks

of adalimumab, while no significant change was noted in erosion score.

An unanticipated finding, however, was lack of improvement in the MRI

synovitis score, despite synovitis improvements in 9 of 19 locations

evaluated.

Conclusions: Improvement in BMO and unchanged erosion scores may

explain the " anti-erosive " effects of adalimumab in PsA. Persistence

of BMO and synovitis on MRI suggests ongoing disease activity and

supports continuation of long-term anti-TNF therapy.

Not an MD

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