RA: up to 40% of patients have silent progression

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Takeaway

  • Disease Activity Score in 28 joints (DAS28) remission may be an insufficient treatment goal in rheumatoid arthritis (RA); including MRI criteria may be necessary as well.

Why this matters

  • Silent progression of bone erosion in the setting of clinical RA remission is raising questions about whether conventional remission criteria are adequate.

Key results

  • 71/80 patients experienced improved DAS28(C-reactive protein [CRP]) between the 2 points, of whom 48% (34/71) achieved European League Against Rheumatism (EULAR) remission.
  • However, 41% (29/71) of those with improved DAS28(CRP) experienced increased (worse) RA MRI Score (RAMRIS) erosion subscores.
  • Increased erosions vs baseline were noted in 71.4% (5/7) of EULAR nonresponders, 52.6% (10/19) moderate responders, and 31.1% (14/45) good responders.
  • Results were similar between early and late RA.
  • ...