Journal article
Effect of a treat-to-target strategy based on methotrexate and intra-articular betamethasone with or without additional cyclosporin on MRI-assessed synovitis, osteitis, tenosynovitis, bone erosion, and joint space narrowing in early rheumatoid arthritis: results from a 2-year randomized double-blind placebo-controlled trial (CIMESTRA)
Rigshospitalet1
University of Southern Denmark2
Department of Electrical Engineering, Technical University of Denmark3
Center for Magnetic Resonance, Department of Electrical Engineering, Technical University of Denmark4
Center for Hyperpolarization in Magnetic Resonance, Centers, Technical University of Denmark5
Hvidovre Hospital6
Copenhagen University Hospital Herlev and Gentofte7
Slagelse Hospital8
Sheba Medical Center at Tel Hashomer9
King Christian X Hospital for Rheumatic Diseases10
Aarhus University Hospital11
University Hospital Herlev12
Odense University Hospital13
ZiteLab ApS14
Vejle Hospital15
...and 5 moreObjectives: To investigate whether a treat-to-target strategy based on methotrexate (MTX) and intra-articular (IA) betamethasone suppresses magnetic resonance imaging (MRI)-determined measures of disease activity and reduces joint destruction in early rheumatoid arthritis (eRA) patients, and to investigate whether concomitant cyclosporin A (CyA) provides an additional effect.Method: In the 2-year randomized, double-blind, treat-to-target trial CIMESTRA, 160 patients with eRA (<6months) were randomized to MTX, intra-articular betamethasone and CyA, or placebo CyA.
A total of 129 patients participated in the MRI substudy, and had contrast-enhanced MR images of the non-dominant hand at months 0, 6, 12, and 24. MR images were evaluated for osteitis, synovitis, tenosynovitis, bone erosion, and joint space narrowing (JSN), using validated scoring methods.Results: Significant reductions were seen at 6months in all inflammatory parameters [synovitis, mean change -1.6 (p
Language: | English |
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Publisher: | Taylor & Francis |
Year: | 2017 |
Pages: | 335-345 |
ISSN: | 15027732 , 03009742 , 15027740 and 03013847 |
Types: | Journal article |
DOI: | 10.1080/03009742.2016.1209550 |
ORCIDs: | 0000-0002-5475-7610 and Hanson, Lars G. |
Adult Aged Antirheumatic Agents Arthritis, Rheumatoid Betamethasone Bone Diseases Cyclosporine Double-Blind Method Drug Administration Routes Drug Delivery Systems Drug Monitoring Drug Therapy, Combination Female Humans Journal Article Magnetic Resonance Imaging Male Methotrexate Middle Aged Patient Acuity Randomized Controlled Trial Synovitis Tendinopathy Treatment Outcome