Correlation of F-FDG PET/CT assessments with disease activity and markers of inflammation in patients with early rheumatoid arthritis following the initiation of combination therapy with triple oral antirheumatic drugs.

Roivainen, Anne; Hautaniemi, Sannamari; Möttönen, Timo; Nuutila, Pirjo; Oikonen, Vesa; Parkkola, Riitta; Pricop, Luminita; Ress, Rudyard; Seneca, Nicholas; Seppänen, Marko; Yli-Kerttula, Timo

Purpose: This study evaluated the potential of functional imaging to monitor disease activity and response to treatment with disease-modifying antirheumatic drugs (DMARD) in DMARD-naive patients with early rheumatoid arthritis (RA). Methods: The study involved 17 patients with active RA in whom combination therapy was initiated with methotrexate, sulfasalazine, hydroxychloroquine, and low-dose oral prednisolone. Clinical disease activity was assessed at screening, at baseline and after 2, 4, 8 and 12 weeks of therapy. F-FDG PET/CT of all joints was performed at baseline and after 2 and 4 weeks of therapy. Results: F-FDG maximum standardized uptake values showed a reduction of 22 ± 13 % in 76 % of patients from baseline to week 2 and a reduction of 29 ± 13 % in 81 % of patients from baseline to week 4. The percentage decrease in F-FDG uptake from baseline to week 2 correlated with clinical outcome, as measured by the disease activity score (DAS-28) at week 12. In addition, changes in C-reactive protein levels and erythrocyte sedimentation rate were positively associated with changes shown by PET. Conclusion: F-FDG PET/CT findings after 2 and 4 weeks of triple combination oral DMARD therapy correlated with treatment efficacy and clinical outcome in patients with early RA. F-FDG PET/CT may help predict the therapeutic response to novel drug treatments.

ANTIRHEUMATIC agents; POSITRON emission tomography; RHEUMATOID arthritis; METHOTREXATE; PREDNISOLONE

European Journal of Nuclear Medicine & Molecular Imaging, 2013, Vol 40, Issue 3, p403

1619-7070

Academic Journal

10.1007/s00259-012-2282-x