在一项随机安慰剂对照试验中对手足部位的OMERACT银屑病关节炎磁共振成像评分（PsAMRIS）进行验证。
Validation of the OMERACT Psoriatic Arthritis Magnetic Resonance Imaging Score (PsAMRIS) for the Hand and Foot in a Randomized Placebo-controlled Trial.
作者信息
Glinatsi Daniel, Bird Paul, Gandjbakhch Frederique, Mease Philip J, Bøyesen Pernille, Peterfy Charles G, Conaghan Philip G, Østergaard Mikkel
机构信息
From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, University of Copenhagen; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of NSW, Sydney, Australia; Pitié Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Swedish Medical Center and University of Washington, Seattle, Washington, USA; Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences Inc., Boca Raton, Florida, USA; and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.D. Glinatsi, MD, Research Fellow, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié Salpêtrière Hospital, APHP, Université Paris 6-UPMC; P.J. Mease, MD, Swedish Medical Center and University of Washington; P. Bøyesen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup and Department of Clinical Medicine, University of Copenhagen.
出版信息
J Rheumatol. 2015 Dec;42(12):2473-9. doi: 10.3899/jrheum.141010. Epub 2015 Nov 1.
OBJECTIVE
To assess changes following treatment and the reliability and responsiveness to change of the Outcome Measures in Rheumatology (OMERACT) Psoriatic Arthritis Magnetic Resonance Imaging Score (PsAMRIS) in a randomized controlled trial.
METHODS
Forty patients with PsA randomized to either placebo or abatacept (ABA) had MRI of either 1 hand (n = 20) or 1 foot (n = 20) at baseline and after 6 months. Images were scored blindly twice by 3 independent readers according to the PsAMRIS (for synovitis, tenosynovitis, periarticular inflammation, bone edema, bone erosion, and bone proliferation).
RESULTS
Inflammatory features improved numerically but statistically nonsignificantly in the ABA group but not the placebo group. Baseline intrareader intraclass correlation coefficients (ICC) were good (≥ 0.50) to very good (≥ 0.80) for all features in both hand and foot. Baseline interreader ICC were good (ICC 0.72-0.96) for all features, except periarticular inflammation and bone proliferation in the hand and tenosynovitis in the foot (ICC 0.25-0.44). Intrareader and interreader ICC for change scores varied. Guyatt's responsiveness index (GRI) was high for inflammatory features in the hand and metatarsophalangeal joints (GRI -0.67 to -3.13; bone edema not calculable). Minimal change and low prevalence resulted in low ICC and GRI for bone damage.
CONCLUSION
PsAMRIS showed overall good intrareader agreement in the hand and foot, and inflammatory feature scores were responsive to change, suggesting that PsAMRIS may be a valid tool for MRI assessment of hands and feet in PsA clinical trials.
目的
在一项随机对照试验中，评估治疗后的变化以及风湿病结局测量（OMERACT）银屑病关节炎磁共振成像评分（PsAMRIS）对变化的可靠性和反应性。
方法
40例银屑病关节炎患者被随机分为安慰剂组或阿巴西普（ABA）组，在基线和6个月后对1只手（n = 20）或1只脚（n = 20）进行MRI检查。3名独立阅片者根据PsAMRIS（用于滑膜炎、腱鞘炎、关节周围炎症、骨水肿、骨侵蚀和骨增殖）对图像进行两次盲法评分。
结果
ABA组炎症特征在数值上有所改善，但无统计学意义，而安慰剂组无改善。双手和双脚所有特征的基线阅片者内部类内相关系数（ICC）均为良好（≥0.50）至非常好（≥0.80）。除手部关节周围炎症和骨增殖以及足部腱鞘炎外，所有特征的基线阅片者间ICC均为良好（ICC 0.72 - 0.96）（手部关节周围炎症和骨增殖以及足部腱鞘炎的ICC为0.25 - 0.44）。变化评分的阅片者内部和阅片者间ICC各不相同。手部和跖趾关节炎症特征的盖亚特反应性指数（GRI）较高（GRI -0.67至-3.13；骨水肿无法计算）。骨损伤的最小变化和低患病率导致ICC和GRI较低。
结论
PsAMRIS在手部和足部显示出总体良好的阅片者内部一致性，炎症特征评分对变化有反应，表明PsAMRIS可能是银屑病关节炎临床试验中手部和足部MRI评估的有效工具。
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