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A Longitudinal Evaluation of Bone Erosive Damage in the Metacarpophalangeal Joints of Patients with Rheumatoid Arthritis Using Early Erosions in Rheumatoid Arthritis (EERA) Software

In this longitudinal pilot study, magnetic resonance imaging (MRI) and Early
Erosions in Rheumatoid Arthritis (EERA) software were used to quantify bone erosive
damage in the metacarpophalangeal (MCP) 2-5 joints of the worst-affected hand (i.e.
greatest swelling and tenderness at baseline) of patients with rheumatoid arthritis (n=35).
Firstly, Spearman’s rho (rs) was used to evaluate the correlation between total change in
sum erosive damage and change in functional ability, as well as the correlation between
rate of change in sum erosive damage and change in functional ability. The rs (p-value)
for total change and rate of change in sum erosive damage was 0.099 (0.585) and 0.104
(0.565), respectively. Therefore, the null hypothesis that neither variable was associated
with change in functional ability could not be rejected. Participants were also classified
into three groups based on total change in sum erosive damage (improvement, stable or
progression) and were examined for possible differences in a variety of measures using an
exploratory, non-statistical approach. Most notably, participants in the improvement
group had more than five times the mean sum erosive damage at baseline compared to the
progression group and also appeared to be the least aggresively medicated of the three
cohorts. This study is the first to apply EERA in a way that helps to address clinically
important questions related to change in erosive damage and functional ability. Future
studies should use the ideas and concepts generated in this pilot study to further explore
the use of this highly reproducible erosion quantification software, with the ultimate goal
of expanding the applications of EERA in both the research and clinical settings. / Thesis / Master of Science (MSc) / In this study, the hands of patients with rheumatoid arthritis (RA) were assessed
using magnetic resonance imaging (MRI) to investigate how erosive damage to the bone
changes over time. Specialized computer software entitled Early Erosions in Rheumatoid
Arthritis (EERA) was used to perform this analysis. Firstly, change in erosive damage
was not found to be related to change in functional ability (e.g. eating, grip, etc.).
Secondly, it appeared that individuals who demonstrated improvement in bone damage
over time had significant damage at the beginning of the study period. Overall, this study
provides new information for researchers and clinicians in terms of how this unique
software can be used to enhance our understanding of RA. Future studies will continue to
explore ways in which this software can be applied to address questions that are important
to RA patients.

Identiferoai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/18162
Date11 1900
CreatorsTomizza, Michael A.
ContributorsAdachi, Jonathan, Medical Sciences (Division of Physiology/Pharmacology)
Source SetsMcMaster University
LanguageEnglish
Detected LanguageEnglish
TypeThesis

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