Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands.
Department of Radiology & Nuclear Medicine, Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands.
RMD Open. 2022 Feb;8(1). doi: 10.1136/rmdopen-2021-002108.
To determine whether macrophage positron emission tomography (PET)/computed tomography (CT) imaging using ()-[C]PK11195 at 0 and 2 weeks is associated with clinical response at 13 weeks in patients with early rheumatoid arthritis (RA).
Whole-body ()-[C]PK11195 PET/CT scans were performed at baseline and after 2 weeks of COBRA-light (combination therapy of methotrexate and prednisone) treatment in 35 patients with clinically active early RA. Clinical assessment (Disease Activity Score of 44 joints (DAS44)) was performed at 0, 2 and 13 weeks of treatment. PET/CT scans were assessed visually by two blinded, experienced readers, and by calculating standardised uptake values (SUVs) for shoulders, elbows, hips, knees, and hand and feet joints. Clinical and PET variables were compared using (multivariate) linear regression.
18 males and 17 females were included (baseline DAS44=3.2 ± 1.0). 171 out of 1470 joints were visually PET positive at baseline, decreasing to 100 joints after 2 weeks. In general, small feet joints showed the highest uptake at baseline, and the largest decrease after 2 weeks (Δ). Neither baseline nor Δ PET measures correlated with DAS44 at 13 weeks. However, at 2 weeks, average SUV of the feet significantly correlated with DAS44 at 13 weeks (R=0.14, p=0.04). In a multivariable model, DAS44 and average SUV of the feet at 2 weeks showed substantial combined predictive value (combined R=0.297, p<0.01).
Quantitative macrophage PET assessment of feet joints, together with DAS44, after 2 weeks of COBRA light treatment in patients with early RA correlates with clinical response after 3 months of treatment.
确定巨噬细胞正电子发射断层扫描（PET）/计算机断层扫描（CT）使用[C]PK11195 成像在 0 周和 2 周时是否与早期类风湿关节炎（RA）患者 13 周时的临床反应相关。
对 35 例临床活动性早期 RA 患者在 COBRA-light（甲氨蝶呤和泼尼松联合治疗）治疗后 2 周进行全身[C]PK11195 PET/CT 扫描。在治疗的 0、2 和 13 周时进行临床评估（44 个关节疾病活动评分（DAS44））。PET/CT 扫描由两位经验丰富的盲法读者进行视觉评估，并计算肩部、肘部、臀部、膝盖、手和脚关节的标准化摄取值（SUV）。使用（多元）线性回归比较临床和 PET 变量。
纳入 18 名男性和 17 名女性（基线 DAS44=3.2±1.0）。基线时 1470 个关节中有 171 个关节 PET 阳性，2 周后减少到 100 个关节。一般来说，小脚部关节在基线时摄取量最高，2 周后下降幅度最大（Δ）。基线和Δ PET 测量均与 13 周时的 DAS44 不相关。然而，在 2 周时，脚部的平均 SUV 与 13 周时的 DAS44 显著相关（R=0.14，p=0.04）。在多变量模型中，DAS44 和 2 周时脚部的平均 SUV 显示出很强的联合预测价值（联合 R=0.297，p<0.01）。
在早期 RA 患者接受 COBRA light 治疗 2 周后，对脚部关节进行定量巨噬细胞 PET 评估，与治疗 3 个月后的临床反应相关。
