Journal of Rheumatology, Journal of Rheumatology, p. jrheum.181385
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Objective The Tight Control of Psoriatic arthritis (TICOPA, ISCRCTN30147736) trial, compared standard care (StdC) and tight control (TC) in early PsA, demonstrating better outcomes for TC. This sub-study evaluated the performance metrics of modern imaging outcomes and compared them to the clinical data. Methods Non-contrast 0.2TMRI (single hand) was assessed using the OMERACT PsAMRIS with an additional global inflammation score. Ultrasound (US, same hand) was scored for grey scale, power Doppler and erosions at the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints and scores summated. Results 78 patients had paired (baseline and 48 weeks) US data and 63 paired MRI data; 50 had matched clinical, MR and US data. Significant within-group changes were seen for the inflammatory PsAMRIS components at MCP level: MRI global inflammation (Median difference (range), Standardised Response Mean, SRM): 3.25 (- 5.0 – 12.0) 0.68, 1.0 (-4.5 – 17.5), 0.45 for TC and StdC respectively. Similar within group differences were obtained for US: 1.0 (-13.0 – 23.0), 0.45, 3.0 (-6.0 – 21.0), 0.77 for TC and StdC respectively. No differences were seen between treatment groups. Significant correlations were found between baseline and change MRI and US scores. A significant correlation was found between baseline PsA disease activity scores and MRI global inflammation scores (Spearman’s rho for MCP, PIP 0.46, 0.63 respectively). No differences in erosion progression were observed. Conclusion The PsAMRIS and US inflammation scores demonstrated good responsiveness. No between group differences were demonstrated but this sub-study was likely underpowered to determine differences between the two treatment strategies.