Assessing the value of whole body magnetic resonance imaging as to clinical examination to predict remission and relapse in early peripheral spondyloarthritis

Background Evaluation of disease activity and treatment response in peripheral spondyloarthritis (pSpA) is currently based upon clinical findings, laboratory tests and ultrasound examination. Whole-body magnetic resonance imaging (WB MRI) is a relatively new imaging technique that could offer additional information regarding the inflammatory status of joints, entheses and soft tissues. Objectives To determine A) the value of WB MRI, performed at baseline, in relation to clinical remission in pSpA and B) the value of subclinical inflammation, detected by WB MRI, at time of clinical remission in predicting flare after treatment withdrawal in pSpA. Methods Clinical REmission in peripheral SPondyloArthritis (CRESPA) is a placebo-controlled trial of golimumab treatment in 60 early (symptom duration Results Pts reaching clinical remission had significant lower baseline BME sum scores then the non-remission group (mean 1.86 vs. 2.89, p=0.024). At the time of clinical remission 10/45 (22%) and 11/45 (24%) pts had residual talocrural and subtalar synovitis respectively. However, there was no statistically significant difference between patients who relapsed after treatment withdrawal and those who remained in remission concerning synovitis sum scores (p=0.497) as well as BME sum scores (p=0.741) and STI sum scores (p=0.131) at time of clinical remission (table 1). Conclusions Early pSpA pts who reach clinical remission have less BME on baseline WB MRI compared to those with ongoing disease activity. At time of clinical remission, a substantial part of the participants showed residual ankle synovitis on MRI. However, residual inflammatory lesions detected by WB MRI did not differ significantly between pts who relapsed after treatment withdrawal and those in ongoing clinical remission. Disclosure of Interest None declared