Evidence map›Paper›PMID 37094363›Full record

ArticleArthritis & rheumatology (Hoboken, N.J.)2023

The Natural Sequence in Which Subclinical Inflamed Joint Tissues Subside or Progress to Rheumatoid Arthritis: A Study of Serial MRIs in the TREAT EARLIER Trial.

Doortje I Krijbolder, Xanthe M E Matthijssen, Bastiaan T van Dijk, Hanna W van Steenbergen, Debbie M Boeters, Annemiek Willemze, Anne A Schouffoer, Annette H M van der Helm-van Mil

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Arthritis & rheumatology (Hoboken, N.J.), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Doortje I KrijbolderDepartment of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.ORCID 0000-0003-1654-1031
Xanthe M E MatthijssenDepartment of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.ORCID 0000-0001-7332-8072
Bastiaan T van DijkDepartment of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.ORCID 0000-0002-5161-6791
Hanna W van SteenbergenDepartment of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
Debbie M BoetersDepartment of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
Annemiek WillemzeDepartment of Rheumatology and Clinical Immunology, Maasstad Hospital, Rotterdam, The Netherlands.
Anne A SchouffoerDepartment of Rheumatology, Leiden University Medical Center, Leiden, and Department of Rheumatology, Haga Hospital, The Hague, The Netherlands.
Annette H M van der Helm-van MilDepartment of Rheumatology, Leiden University Medical Center, Leiden, and Department of Rheumatology, Erasmus Medical Center, Rotterdam, The Netherlands.
Leiden University Medical Center · NLLeiden University · NLMaasstad Ziekenhuis · NL

Funding

European Research Council 714312
6 · The paper itself

Abstract

objectiveThe natural trajectory of clinical arthritis progression at the tissue level remains elusive. We hypothesized that subclinical inflammation in different joint tissues (synovitis, tenosynovitis, osteitis) increases in a distinct temporal order in patients with clinically suspect arthralgia (CSA) who develop rheumatoid arthritis (RA) and subsides in a different sequence when CSA spontaneously resolves.

methodsWe studied 185 serial magnetic resonance images (MRIs) from CSA patients with subclinical joint inflammation from the placebo arm of the TREAT EARLIER trial: 52 MRIs from 21 RA progressors (MRIs conducted at 1 year before, at 4 months before, and upon RA development), and 133 MRIs from 35 patients with spontaneous resolution of pain (MRIs conducted at baseline and at 4, 12, and 24 months). MRIs were scored for osteitis, synovitis, and tenosynovitis. We used cross-lagged models to evaluate 2 types of time patterns between pairs of inflamed tissues: a simultaneous pattern (coinciding changes) and a subsequent pattern (inflammatory changes in 1 tissue preceding changes in another tissue).

resultsIn patients who developed RA, synovitis, tenosynovitis, and osteitis increased simultaneously. Increasing osteitis occurred in the final 4 months before RA diagnosis, following incremental tenosynovitis and synovitis changes during the 1 year to 4 months before diagnosis (P < 0.01). In anti-citrullinated protein antibody (ACPA)-positive and ACPA-negative patients who progressed to RA, osteitis increased just before RA development. In patients with pain resolution, simultaneous decreases in synovitis, tenosynovitis, and osteitis occurred, with tenosynovitis decreasing in the first 4 months after CSA onset preceding decreasing synovitis and osteitis during 4-12 months (P = 0.02 and P < 0.01).

conclusionWe identified natural sequences of subclinical inflammation in different joint tissues, which deepens our understanding of clinical arthritis and RA development. During RA progression, increasing osteitis followed previous increases in tenosynovitis and synovitis. During pain resolution, tenosynovitis decreased first, followed by decreasing synovitis and osteitis.

Indexed as

Arthritis, RheumatoidOsteitisSynovitisTenosynovitisArthralgiaHumansInflammationMagnetic Resonance Imaging

Identifiers

PMID37094363
PMCPMC7615887
OpenAlexW4366816179

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.