Early MRI measures independently predict 1-year and 2-year radiographic progression in rheumatoid arthritis: secondary analysis from a large clinical trial

Ann Rheum Dis. 2014 Nov;73(11):1968-74. doi: 10.1136/annrheumdis-2013-203444. Epub 2013 Jul 31.


Objective: To determine if early MRI measures predict X-ray progression at 1 and 2 years in a large RA trial cohort.

Design: This study included 256 methotrexate (MTX)-naïve RA patients from a randomised placebo-controlled trial of golimumab (GO-BEFORE). MRIs of wrist and 2nd-5th metacarpophalangeal joints at 0, 12, 24, 52 and 104 weeks were obtained and scored using the RAMRIS system. Multivariable logistic regression examined if baseline and early change (weeks 12/24) in RAMRIS scores independently predicted progression of the van der Heijde-Sharp (vdHS) score and MRI erosion score at 1 and 2 years of follow-up.

Results: High baseline score and poor improvement over the first 24 weeks in synovitis (p=0.003 and p=0.003, respectively) and in bone oedema (p=0.02 and p=0.001, respectively) were independent predictors of X-ray progression at 1 year. Associations were significant or tended towards an association at 2 years. An increase in RAMRIS bone erosion >0.5 at weeks 12 and 24 also predicted X-ray progression (p<0.003). Poor 12-week improvement in bone oedema was associated with X-ray and MRI progression at 1 year (p<0.05). Regression models that incorporated baseline and 12-week and 24-week changes in MRI measures of synovitis (AUC=0.71) and bone oedema (AUC=0.70) improved the prediction of X-ray progression at 1 year above clinical disease activity alone (AUC=0.66, p<0.04).

Conclusions: Baseline and early changes in MRI measures independently predicted X-ray and MRI progression at later time-points. The predictive validity established here supports potential use in shorter-duration studies to determine efficacy of RA therapies in preventing structural damage.

Keywords: Disease Activity; Magnetic Resonance Imaging; Rheumatoid Arthritis.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Antibodies, Monoclonal / therapeutic use
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / complications
  • Arthritis, Rheumatoid / diagnosis*
  • Arthritis, Rheumatoid / drug therapy
  • Bone Marrow Diseases / diagnosis
  • Bone Marrow Diseases / etiology
  • Disease Progression
  • Drug Therapy, Combination
  • Early Diagnosis
  • Edema / diagnosis
  • Edema / etiology
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Metacarpophalangeal Joint / diagnostic imaging
  • Metacarpophalangeal Joint / pathology
  • Methotrexate / therapeutic use
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Radiography
  • Synovitis / diagnosis
  • Synovitis / etiology
  • Wrist Joint / diagnostic imaging
  • Wrist Joint / pathology


  • Antibodies, Monoclonal
  • Antirheumatic Agents
  • golimumab
  • Methotrexate