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Assessing joint destruction in the knees of patients with rheumatoid arthritis by using a semi-automated software for magnetic resonance imaging: therapeutic effect of methotrexate plus etanercept compared with methotrexate monotherapy
Authors:Hiroyuki Oka  Yuho Kadono  Satoru Ohashi  Tetsuro Yasui  Kumiko Ono  Ko Matsudaira
Affiliation:1. Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical &2. Research Center, The University of Tokyo, Tokyo, Japan;3. Department of Orthopaedic Surgery, Saitama Medical University, Saitama, Japan;4. Department of Orthopaedic Surgery, Sagamihara Hospital, National Hospital Organization, Kanagawa, Japan;5. Department of Orthopaedic Surgery, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan;6. Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
Abstract:
Objectives: To evaluate the prevention of knee joint destruction and clinical efficacy of methotrexate (MTX) plus etanercept (ETN) compared with MTX monotherapy in patients with rheumatoid arthritis (RA) by using semi-automated software for magnetic resonance imaging (MRI) scan analysis.

Materials and methods: This study enrolled patients with active moderate-to-severe RA who displayed an inadequate response to oral MTX at screening. Patients were assigned to receive either MTX plus ETN or MTX monotherapy (≥10?mg/week). The primary endpoint was the quantitative knee cartilage volume using our software developed for MRI scan analysis.

Results: A total of 18 female patients were enrolled in this study and allocated to the MTX?+?ETN group (n?=?9) or the MTX monotherapy group (n?=?9). At 52 weeks, the quantitative knee cartilage volume was significantly reduced compared with baseline in both groups (MTX plus ETN group: 2.3?±?2.3?cm3; MTX monotherapy group: 2.4?±?1.6?cm3); however, the difference was not significant.

Conclusion: The semi-automated software for MRI scan analysis can reveal useful and potentially clinically important information about the characteristics of knee joint destruction in patients with RA.
Keywords:Cartilage  etanercept  magnetic resonance imaging  methotrexate  rheumatoid arthritis
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