MRI parametric monitoring of biological therapies in primary large vessel vasculitides

• Verfasst von: Spira, Daniel [VerfasserIn]
• Titel: MRI parametric monitoring of biological therapies in primary large vessel vasculitides
• Titelzusatz: a pilot study
• Verf.angabe: Daniel Spira, MD, Theodoros Xenitidis, MD, Jörg Henes, MD and Marius Horger, MD
• E-Jahr: 2016
• Jahr: January 08, 2016
• Umfang: 7 S.
• Fussnoten: Gesehen am 12.05.2020
• Titel Quelle: Enthalten in: BJR case reports
• Ort Quelle: London : BIR Publications, 2015
• Jahr Quelle: 2016
• Band/Heft Quelle: 89(2016,1058) Artikel-Nummer 20150892, 7 Seiten
• ISSN Quelle: 2055-7159
• DOI: doi:10.1259/bjr.20150892
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1698041225

Abstract

Objective:To evaluate the development of characteristic MRI changes in patients with primary large-vessel vasculitis (LVV) when treated with biological therapies.Methods:12 patients with primary LVV (8 patients with Takayasu arteritis and 4 patients with giant-cell arteritis) received biological therapy with tumour necrosis factor-α blockers (n = 9) or an interleukin-6 inhibitor (n = 3). MRI investigations were performed at baseline (pre-treatment) and follow-up. All patients underwent the same MRI/MR angiography (MRA) protocol. Laboratory parameters (C-reactive protein and erythrocyte sedimentation rate) and clinical response (Birmingham Vasculitis Activity Score) were assessed.Results:Wall thickness was 4.2 ± 0.3 mm pre-treatment and significantly decreased to 3.2 ± 0.3 mm post treatment in 9/12 patients. Mural enhancement was increased in all 12/12 patients with LVV, and subsided with therapy in 5/12 patients. Mural oedema or ill-defined contour were less prevalent but also improved with biological treatment. C-reactive protein and erythrocyte sedimentation rate levels decreased, and clinical assessment revealed a significant improvement from pre-treatment to post-treatment. However, the course of imaging characteristics often did not parallel that of laboratory or clinical parameters. In all three patients receiving interleukin-6 blockade, laboratory markers and clinical scores normalized despite persistent vascular inflammation in one patient which was disclosed by MRI.Conclusion:Contrast-enhanced MRI/MRA may be useful when evaluating the development of disease activity in primary LVV under biological therapies. A high degree of suspicion and regular imaging follow-up is needed to detect persistent inflammation.Advances in knowledge:This is the first study investigating the applicability of different MRI/MRA parameters for monitoring biological therapy in patients with primary LVV.