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Published on: November 28, 2025
Relationship of patient-reported outcomes with MRI measures in rheumatoid arthritis
Joshua F Baker1,2,3, Philip G Conaghan4, Paul Emery4
1Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA.
Purpose:
We assessed whether MRI measures of synovitis, osteitis and bone erosion were associated with patient-reported outcomes (PROs) in a longitudinal clinical trial setting among patients with rheumatoid arthritis (RA).
Methods:
This longitudinal cohort of 291 patients with RA was derived from the MRI substudy of the GO-BEFORE randomised controlled trial of golimumab among methotrexate-naïve patients. Correlations between RAMRIS scores (synovitis, osteitis, bone erosion) and physical function (Health Assessment Questionnaire (HAQ)), pain and global patient scores were determined at 0, 12, 24 and 52 weeks. Correlations between interval changes were also assessed. Multivariable regression models using robust generalised estimating equations evaluated associations over all time-points and their relationship to other clinical disease activity measures.
Results:
Greater synovitis, osteitis and bone erosion scores were positively associated with HAQ at all time-points (all p<0.05) and with pain and patient global scores at 24 and 52 weeks. Over all visits, synovitis was associated with HAQ, pain and patient global scores (p≤0.03) independent of clinical disease activity measures. Improvements in synovitis and bone erosion were also associated with improvements in PROs. Less improvement in synovitis and progression in MRI erosion at 52 weeks were both independently associated with worsening in all PROs at 52 weeks while progression on X-ray was not associated. Similar associations were observed across treatment groups.
Conclusions:
MRI measures of inflammation and structural damage correlate independently with physical function, pain and patient global assessments. These observations support the validity of MRI biomarkers.
Trial Registration Number:
NCT00264537; Post-results.
Insights
Magnetic Resonance Imaging (MRI) measures of inflammation and bone erosion in rheumatoid arthritis (RA) correlate with patient-reported outcomes, supporting MRI as a valid biomarker for disease assessment.
Area of Science:
- Rheumatology
- Medical Imaging
- Clinical Trials
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by joint inflammation and potential bone damage.
- Patient-reported outcomes (PROs) are crucial for assessing treatment efficacy and disease impact.
- Magnetic Resonance Imaging (MRI) offers detailed visualization of joint structures, including synovitis, osteitis, and bone erosion.
Purpose of the Study:
- To evaluate the association between MRI-detected synovitis, osteitis, and bone erosion and PROs in RA patients.
- To determine if these MRI findings correlate with physical function, pain, and global patient assessments over time.
- To assess the independent predictive value of MRI changes on PROs in a longitudinal clinical trial.
Main Methods:
- A longitudinal cohort of 291 methotrexate-naïve RA patients from the GO-BEFORE trial (golimumab) was analyzed.
- RAMRIS scores for synovitis, osteitis, and bone erosion were correlated with PROs (HAQ, pain, global scores) at multiple time points (0, 12, 24, 52 weeks).
- Multivariable regression models assessed associations between MRI measures, PROs, and clinical disease activity.
Main Results:
- Higher synovitis, osteitis, and bone erosion scores were positively associated with worse physical function (HAQ) and pain at all time points.
- Synovitis independently correlated with HAQ, pain, and global scores, irrespective of clinical disease activity.
- Improvements in synovitis and bone erosion correlated with improvements in PROs; MRI erosion progression was linked to worsening PROs.
Conclusions:
- MRI-derived measures of inflammation and structural damage in RA are independently associated with patient-reported physical function, pain, and global assessments.
- These findings validate the utility of MRI biomarkers in capturing the patient experience of RA.
- MRI is a valuable tool for assessing disease activity and structural changes in RA clinical trials.
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