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Changes in clinical disease activity are weakly linked to changes in MRI inflammation on treat-to-target escalation of therapy in rheumatoid arthritis

Overview of attention for article published in Arthritis Research & Therapy, October 2017
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Title
Changes in clinical disease activity are weakly linked to changes in MRI inflammation on treat-to-target escalation of therapy in rheumatoid arthritis
Published in
Arthritis Research & Therapy, October 2017
DOI 10.1186/s13075-017-1433-7
Pubmed ID
Authors

Fiona M. McQueen, Peter Chapman, Terina Pollock, Dena D’Souza, Arier C. Lee, Nicola Dalbeth, Lisa Stamp, Karen Lindsay, Anthony Doyle

Abstract

Rheumatoid arthritis (RA) treat-to-target (T2T) regimens often use the disease activity score (28 joints) incorporating C-reactive protein (DAS28CRP) as an outcome measure. We compared changes in the DAS28CRP with changes in magnetic resonance imaging (MRI) inflammation on treatment escalation. Eighty seropositive RA patients with active disease were enrolled. Group A (N = 57) escalated to another conventional disease-modifying therapy (cDMARD) combination, and Group B (N = 23) to anti-TNF therapy/cDMARDs. Contrast-enhanced 3T-MRI wrist scans were obtained before and 4 months after regimen change. Scan pairs were scored for inflammation (MRI(i)) and damage. Disease activity was assessed using the DAS28CRP. Eighty patients were enrolled and 66 MRI scan pairs were available for analysis. Intra-reader reliability was high: intraclass correlation coefficient (average) 0.89 (0.56-0.97). ΔDAS28CRP did not differ between groups: Group A, -0.94 (-3.30, 1.61); Group B, -1.53 (-3.59, 0.56) (p = 0.45). ΔMRI(i) also did not differ: Group A, 0 (-25, 10); Group B, -1 (-15, 28) (p = 0.12). Combining groups, ΔMRI(i) correlated weakly with ΔDAS28CRP (Spearman's 0.36, p = 0.003). Using multiple linear regression analysis adjusting for confounders, ΔDAS28CRP was associated with ΔMRI(i) (p = 0.056). Of the individual MRI measures, only Δtenosynovitis correlated with ΔDAS28CRP (Spearman's 0.33, p = 0.007). ΔMRI(i) was negatively associated with the MRI erosion score at entry (p = 0.0052). We report the first study investigating the link between changes in clinical and imaging inflammation in a real-world RA cohort escalating to conventional and biologic DMARDs. The association was significant but relatively weak, suggesting that MRI targets cannot yet be advocated as outcomes for T2T escalation. ANZCTR 12614000895684 . Registered 22 August 2014.

Twitter Demographics

The data shown below were collected from the profiles of 2 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 11 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 11 100%

Demographic breakdown

Readers by professional status Count As %
Unspecified 3 27%
Student > Master 2 18%
Student > Bachelor 2 18%
Student > Ph. D. Student 2 18%
Student > Postgraduate 1 9%
Other 1 9%
Readers by discipline Count As %
Medicine and Dentistry 5 45%
Unspecified 4 36%
Nursing and Health Professions 1 9%
Pharmacology, Toxicology and Pharmaceutical Science 1 9%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 June 2018.
All research outputs
#8,312,606
of 13,799,368 outputs
Outputs from Arthritis Research & Therapy
#1,507
of 2,226 outputs
Outputs of similar age
#170,405
of 316,521 outputs
Outputs of similar age from Arthritis Research & Therapy
#134
of 202 outputs
Altmetric has tracked 13,799,368 research outputs across all sources so far. This one is in the 37th percentile – i.e., 37% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,226 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.7. This one is in the 29th percentile – i.e., 29% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 316,521 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 42nd percentile – i.e., 42% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 202 others from the same source and published within six weeks on either side of this one. This one is in the 30th percentile – i.e., 30% of its contemporaries scored the same or lower than it.