MRI-guided treat-to-target strategy in RA patients in remission not superior to conventional treat-to-target strategy

Using MRI-guided treat-to-target strategy did not improve the rate of disease activity or reduce radiographic progression compared with a conventional treat-to-target strategy in patients with rheumatoid arthritis in clinical remission, reports a new JAMA study, online Feb. 5, 2019.

The 2-year multicenter IMAGINE-RA trial randomized patients with RA in clinical remission, to either MRI-guided treat-to-target strategy or conventional treat-to-target strategy. Results showed that 85% vs 88%, respectively, reached the primary clinical end point (absence of MRI bone marrow edema combined with clinical remission, defined as DAS28-CRP <3.2 with no swollen joints). And, 66% vs 62%, respectively, reached the primary radiographic end point (patients with no radiographic progression) at the end of the study.

These differences are statistically non-significant suggesting no added benefit of the MRI-guided approach in these patients.

Based on their findings, the authors do not recommend use of an MRI-guided treat-to-target strategy for patients with RA in clinical remission.

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA