ArticleACR open rheumatology2026
Quantitative Muscle Magnetic Resonance Imaging Demonstrates Resolution of Muscle Edema in Refractory Dermatomyositis: A Post Hoc Analysis of a Proof-of-Concept Clinical Trial of Tofacitinib.
Article in ACR open rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
objectiveTo evaluate changes in muscle edema using short-tau inversion recovery (STIR) imaging and quantitative diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) mapping in patients with refractory dermatomyositis (DM) treated with tofacitinib.
methodsThis post hoc imaging analysis included patients from a 12-week, open-label trial of tofacitinib 11 mg daily in refractory DM. Bilateral thigh magnetic resonance imaging was obtained at baseline and week 12 using standardized STIR, T1-weighted, and DWI sequences. Muscle edema (ME) and fascial edema were assessed qualitatively on STIR imaging. ADC values were measured in muscles demonstrating baseline STIR hyperintensity using three nonoverlapping regions of interest per muscle. Clinical outcomes included Manual Muscle Testing of eight muscle groups (MMT-8).
resultsTen patients completed the study. Baseline ME was present in 32 of 320 thigh muscles (10%) across four patients. Quantitative ADC analysis, performed in the 32 edematous muscles, demonstrated significant decreases in tissue diffusivity in 11 muscles (34.5%), including the rectus femoris, vastus lateralis, vastus medialis, sartorius, gracilis, and adductors. Absolute ADC reductions ranged from -0.18 to -0.37 × 10
conclusionTofacitinib resulted in marked clinical and radiologic improvement in refractory DM. Quantitative ADC mapping detected resolution of muscle inflammation, including subclinical improvement not evident on strength or enzyme testing. ADC metrics may serve as objective imaging biomarkers of treatment response in DM.
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