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Deutscher Rheumatologiekongress 2021, 49. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 35. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)

15.09. - 18.09.2021, virtuell

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Fluorescence-optical imaging technique discriminates signs of early joint inflammation in patients suspect of Rheumatoid Arthritis in the PANORA trial

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  • Michaela Köhm - Abteilung Rheumatologie, Universitätsklinik Frankfurt, Frankfurt; Fraunhofer-Institut für Translationale Medizin und Pharmakologie, Klinische Forschung, Frankfurt
  • Sarah Ohrndorf - Abteilung Rheumatologie und klinische Immunologie, Charité – Universitätsmedizin Berlin, Berlin
  • Anne-Marie Glimm - Abteilung Rheumatologie und klinische Immunologie, Charité – Universitätsmedizin Berlin, Berlin
  • Stephanie Dauth - Fraunhofer-Institut für Translationale Medizin und Pharmakologie, Klinische Forschung, Frankfurt
  • Ulf Henkemeier - Fraunhofer-Institut für Translationale Medizin und Pharmakologie, Klinische Forschung, Frankfurt; Centrum für Innovative Diagnostik und Therapie Rheumatologie/Immunologie CIRI, Frankfurt
  • Tanja Rossmanith - Fraunhofer-Institut für Translationale Medizin und Pharmakologie, Klinische Forschung, Frankfurt
  • Harald Louis Burkhardt - Abteilung Rheumatologie, Universitätsklinik Frankfurt, Frankfurt; Fraunhofer-Institut für Translationale Medizin und Pharmakologie, Klinische Forschung, Frankfurt; Centrum für Innovative Diagnostik und Therapie Rheumatologie/Immunologie CIRI, Frankfurt
  • Frank Behrens - Abteilung Rheumatologie, Universitätsklinik Frankfurt, Frankfurt; Fraunhofer-Institut für Translationale Medizin und Pharmakologie, Klinische Forschung, Frankfurt; Centrum für Innovative Diagnostik und Therapie Rheumatologie/Immunologie CIRI, Frankfurt

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. Deutscher Rheumatologiekongress 2021, 49. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 35. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). sine loco [digital], 15.-18.09.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocDI.11

doi: 10.3205/21dgrh029, urn:nbn:de:0183-21dgrh0296

Published: September 14, 2021

© 2021 Köhm et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Introduction: Rheumatoid Arthritis (RA) is a chronic inflammatory joint disease affecting about 1% of the European adults. Fluorescence-optical imaging (FOI) technique is an indocyanine-green (ICG) based procedure to assess changes of microvascularization in the hands. Purpose of the study was to investigate if assessment of FOI is of value for early detection and prediction of RA in the ‘at-risk’ population.

Methods: In the PANORA trial, 980 patients with new onset of nsMSK symptoms were recruited by a network of General Practicioners (GP). In case of positivity in anti-CCP point-of-care test (CCPoint®), patients were referred to Rheumatology Department (RD) for further assessments: confirmation of anti-CCP positivity via ELISA, physical examination, joint assessment, ultrasound. Additionally, FOI was performed and assessed using FOIAS (fluorescence optical imaging activity score) according to ICG-distribution [1], [2], [3]. Patients were followed up for 3 years or until RA was diagnosed.

Results: Of the 980 patients, 9.8% (n=94) showed a positive CCPoint® test and were referred to RD. At RD, 21% (n=25) were confirmed anti-CCP-positive by ELISA from which 11 patients were diagnosed with RA at their first visit, 6 in the follow-up (FU) period. FOI assessment showed increased signal intensities (mean) in FOIAS phase (P) 2 in the patients with RA (18.0 vs. 11.6) as well as in the mean P1+P2+P3 (19.8 vs. 16.8 for the no-RA group). Compared to the RA and no RA group from first visit, mean P1+P2+P3 showed increased levels at first visit in the ELISA positive group which developed RA later during follow-up (23.8).

Conclusion: Data from patients suspect of RA and screened using CCPoint® test at GP before referral to RD are reported. FOI assessment discriminates patients with RA to those without by assessment of P2 and P1+P2+P3. Moreover, levels for P1+P2+P3 are increased in the ELISA positive cohort which developed RA later in the FU period. So, FOI might be useful not only in early diagnosis of RA in the ‘at risk’ population, but also for prediction of RA and of additional use for early diagnostic beside serological biomarkers.

Disclosures: Das Forschungsprojekt wurde durch eine Forschungsförderung der Firma BMS gefördert.

Outline

References

1.
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