Japanese researchers seeking to validate the Assessment of Rheumatoid Arthritis by Systemic Histological and radiological Imaging, or ARASHI method of evaluating joint damage by radiograph, found the method is effective in the assessment of progressive joint damage in patients with rheumatoid arthritis undergoing anti-tumor necrosis factor A therapy.
“Radiographic damage is directly correlated to functional disability, overall severity and pain in patients with [rheumatoid arthritis] RA. At present radiographic damage of large joints is commonly evaluated by Larsen grade, which has severe limitations, including a ceiling effect within the grade,” Isao Matsushita, MD, from the Department of Orthopaedic Surgery at the University of Toyama in Toyama Prefecture, Japan, stated in a press release. “These data highlight the need for better scoring and evaluation, without which, progression of damage and patient needs cannot be accurately assessed.”
The ARASHI score is divided into two portions: status score and change score. The four categories in the status score are based on joint narrowing (0 to 3 points), erosion (0 to 4 points), joint surface (0 to 6 points) and stability (0 to 4 points). Change score categories include porosis (-1 to 1 point), joint narrowing (-1 to 2 points), erosion (-2 to 2 points), joint surface (-6 to 6 points) and stability (-1 to 1 points), with an increase of more than 1 point under the ARASHI change score indicates joint damage progression, according to the release.
Matsushita and colleagues evaluated the radiographs of 51 patients undergoing anti-tumor necrosis factor (anti-TNF) A therapy at baseline and at 1 year and 2 years after using anti-TNF therapy.
“Patients with pre-existing damage demonstrated significant increases in the ARASHI change score during 2 years of TNF-blocking therapy; highlighting progressive destruction even under drug therapy,” Matsushita said. “These data show that joints are best protected with early and accurate evaluation, to ensure they do not exceed an ARASHI score of two, prior to the start of drug treatment.”
Ayabe K. Abatacept (ABT) equivalent to anti-tumor necrosis factor A (TNFA) in terms of joint destruction inhibition: Multicenter study of 107 patients treated for 52 weeks. Presented at: European League Against Rheumatism Annual Congress. June 12-15, 2013; Madrid.
Disclosure: The authors have no relevant financial disclosures.