Method: 33 patients with rheumatoid (RA) and psoriatic (PsA) arthritis were examined before starting treatment with DMARD or biological (visit 1) and at follow-up (visit 2 after ≥3 months). Treatment response was assessed using DAS28, locDAI and FOIAS. For locDAI swelling and tenderness were assessed separately and semiquantitativly for 15 joints of both hands (0 = no, 1 = subtle, 2 = distinct swelling/tenderness, distal interphalangeal joints (DIP) 2-5, interphalangeal joints (IP), proximal interphalangeal joint (PIP) 2-5, metacarpophalangeal joint (MCP) 1-5 and wrist, range 0-60) and a sum score was calculated. The FOI (Xiralite, mivenion GmbH, 0.1 mg/kg/BW of ICG i.v. over 6 minutes) sequences were analyzed for the automatically generated composite image (PVM) and three defined phases of FOI (P1, P2, P3). FOI findings of increased signal intensities were valued as 0=no, 1=low, 2=moderate, and 3=strong increased signal intensities. For FOIAS sum scores over all joints (DIP 2-5, PIP 2-5, IP, MCP 1-5, wrist, both hands, range 0-90) for PVM, the phases P1-3 and all phases were calculated. Standardized response means (SRM) were calculated for measurement of treatment response and Wilcoxon signed rank test was used to assess statistical significant change.
Result: The mean DAS28 at visit 1 was 4.3 and 2.9 at visit 2. All scores (DAS28, locDAI, FOIAS) showed a reduction of disease activity from visit 1 to visit 2. The mean reduction was 34% for DAS28, 47% for locDAI and 22%-34% for FOIAS. The SRMs showed high treatment response (SRM >0.8) for DAS28 (SRM -1.26) and locDAI (SRM -0.95) and moderate response (>0.5-0.8) for FOIAS (SRM -0.57 to-0.76) (3). The change from baseline was stated as statistical significant for all scores except FOIAS P1 (p<0.05).
Conclusion: The study suggests that FOI is a suitable tool to assess treatment response in subjects with RA and PsA. Further studies are required to test FOI as a possible additional outcome measure in clinical trails and clinical practice.
(1) Werner S, Schott P, Bahner M et al. Comparison of Xiralite with Clinical Examination and MRI Ann Rheum Dis 2011;70(Suppl3):555 (2)Werner S, Ohrndorf S, Bahner M et al. Comparison of Xiralite with Clinical Examination and Ultrasonography Ann Rheum Dis 2011;70(Suppl3):361 (3) Husted JA, Cook RJ, Farewell VT, et al. Methods for assessing responsiveness: a critical review and recommendations. J Clin Epidemiol 2000;53:459–68.
Disclosure: S. G. Werner, None; F. Spiecker, None; S. Mettler, None; G. Lind-Albrecht, None; C. Schwenke, None; H. E. Langer, None.