Long-term efficacy of a 2-year MRI treat-to-target strategy on disease activity and radiographic progression in patients with rheumatoid arthritis in clinical remission: 5-year follow-up of the IMAGINE-RA randomised trial

Møller-Bisgaard, S; Hørslev-Petersen, K; Ørnbjerg, LM; Ejbjerg, B; Hetland, ML; Møller, JM; Nielsen, SM; Glinatsi, D; Boesen, M; Stengaard-Pedersen, K; Madsen, OR; Jensen, B; Villadsen, JA; Hauge, EM; Hendricks, O; Lindegaard, H; Krogh, NS; Jurik, AG; Thomsen, H; Christensen, R; Østergaard, M

doi:10.1136/rmdopen-2023-003945

Long-term efficacy of a 2-year MRI treat-to-target strategy on disease activity and radiographic progression in patients with rheumatoid arthritis in clinical remission: 5-year follow-up of the IMAGINE-RA randomised trial

RMD OpenPublished 15 Mar 2024Observational extension study of the IMAGINE-RA randomised trial

Primary result · Co-primary: DAS28-CRP remission (DAS28-CRP<2.6)ResultOR for DAS28-CRP remission 2.00 95% CI 0.76–5.28

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Authors' conclusion

A 2-year combined MRI and clinical treat-to-target strategy, compared with a conventional clinical treat-to-target strategy alone, had no effect on the long-term probability of achieving DAS28-CRP remission and of avoiding radiographic progression.

Study context

Population: Patients with RA in clinical remission (mean age 61.2, disease duration 9.5 years)86 women (67%)
Participants: 131 patients

Comparison: 2-year MRI treat-to-target strategy (absence of osteitis plus clinical remission) vs conventional treat-to-target strategy (clinical remission only)
MRI treat-to-targetn = 59
Conventionaln = 72reference
Primary endpoint: Coprimary: DAS28-CRP remission rate (DAS28-CRP<2.6) and no radiographic progression (vdHSS ≤0) from baseline
Follow-up: Year 5

Methodological details5-year follow-up, prespecified coprimary outcomes

5-year follow-up
Prespecified coprimary outcomes

Primary result

Co-primary: DAS28-CRP remission (DAS28-CRP<2.6)

OR for DAS28-CRP remission

2.00

95% CI 0.76–5.28

P = 0.16

Events by treatment group

MRI treat-to-target80%47 of 59

Conventional treat-to-target75%54 of 72

MRI treat-to-targetvs Conventional treat-to-target

OR for DAS28-CRP remission 2.00 (95% CI 0.76–5.28); P = 0.16

As reported in the abstract

Secondary outcomes

Outcome	MRI treat-to-target	Conventional	← Lower odds with MRI treat-to-target ←→ Higher odds with MRI treat-to-target →	OR (95% CI)	P value
Coprimary: no radiographic progression (vdHSS ≤0) · year 5	24%	26%	0.20.5125	0.70 (0.28–1.71)	P = 0.43
			0.20.5125Odds ratio (log scale)

Original publication

Long-term efficacy of a 2-year MRI treat-to-target strategy on disease activity and radiographic progression in patients with rheumatoid arthritis in clinical remission: 5-year follow-up of the IMAGINE-RA randomised trial. RMD Open. Published 15 March 2024. doi:10.1136/rmdopen-2023-003945

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