Artikel
Fluorescence-optical imaging technique in detection of psoriatic arthritis in psoriasis patients
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Autoren
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Michaela Köhm
- Rheumatology Department, Goethe-University Hospital Frankfurt; Fraunhofer IME, Translational Medicine & Pharmacology TMP; Fraunhofer Cluster of Excellence Immune-mediated Diseases CIMD
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Sarah Ohrndorf
- Rheumatologie Universitätsmedizin Charité Berlin
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Tanja Roßmanith
- Fraunhofer IME, Translational Medicine & Pharmacology TMP; Fraunhofer Cluster of Excellence Immune-mediated Diseases CIMD
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Marina Backhaus
- Parkklinik Weißensee Berlin
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Gerd Burmester
- Rheumatologie Universitätsmedizin Charité Berlin
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Siegfried Wassenberg
- Rheumazentrum Ratingen
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Benjamin Köhler
- Rheumazentrum Ratingen
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Harald Burkhardt
- Rheumatology Department, Goethe-University Hospital Frankfurt; Fraunhofer IME, Translational Medicine & Pharmacology TMP; Fraunhofer Cluster of Excellence Immune-mediated Diseases CIMD
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Frank Behrens
- Rheumatology Department, Goethe-University Hospital Frankfurt; Fraunhofer IME, Translational Medicine & Pharmacology TMP; Fraunhofer Cluster of Excellence Immune-mediated Diseases CIMD
| Veröffentlicht: | 9. September 2020 |
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Gliederung
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Introduction: Psoriatic arthritis (PsA) is closely associated to Pso: Up to 30% of Pso patients develop PsA. In early PsA, changes in synovial vascularisation combined with increased expression of proangiogenic factors appear first. Therefore, imaging biomarkers for detection of changes in vascularisation might be useful for early detection of musculoskeletal (msk) disease. Fluorescence-optical imaging (FOI) is a new method to detect changes in microvascularisation of the hands.
Methods: Sensitivity of FOI for detection of subclinical msk-inflammation was observed in a prospective, multicentre study (XCITING) including patients with dermatological confirmed psoriasis. 411 patients without diagnosis of PsA but potential risk factors for its development (nail psoriasis and/or joint pain or swelling within the last 6 months) were included. Clinical examination (CE; swollen (66) and tender (68) joint count, enthesitis, dactylitis assessment) and standardised ultrasound (US) and FOI assessment were performed by a qualified rheumatologist to assess msk-inflammation. Data was analysed in focus on inflammatory markers. In case of discrepant results (positive FOI and negative CE and US), MRI was performed to prove the findings. In case of MRI negativity, a follow-up period of 24-months was performed including FOI, CE, US and MRI assessment.
Results: 83 of the 411 patients of the cohort were negative in all assessments (Pso only), 136 of the 411 patients were classified as PsA by rheumatologic assessments. 119 patients showed subclinical msk-inflammation in FOI central reading, whereas CE and US were negative. In 37,5% of those patients, subclinical inflammation was confirmed by MRI assessment. 22 patients without MRI positivity were willing to be followed up until 24-months. 5 (7.5%) patients developed clinical PsA. In 5 patients an additional MRI-examination was performed in which one patient showed positive signs for inflammation.
Conclusion: FOI is an innovative method for measurement of changes in microvascularisation in the hands. In 33% of the PsO patients, PsA was confirmed by clinical examination only. In another 29%, subclinical msk-inflammation was detected by FOI, confirmed in 37,5% by MRI. In the 24-months follow-up, in another 9% of the patients PsA was detected. FOI increases the probability to diagnose PsA early compared to CE only.
Figure 1 [Fig. 1]
Disclosures: All authors: Grant/research support from Pfizer.
