Prospective, simultaneous assessment of joint and vascular inflammation by PET/CT in tofacitinib-treated patients with rheumatoid arthritis: associations with vascular and bone status

Abstract Objectives Efficacy evaluation of giant cell arteritis (GCA) treatment is primarily based on non-specific symptoms and laboratory markers. We aimed to assess the change in vascular inflammation in patients with large vessel (LV)-GCA under different treatments using [18F]FDG PET/CT. Methods Observational study on patients with new-onset, active LV-GCA starting treatment with either prednisolone monotherapy (PRED) or combination with methotrexate (MTX) or tocilizumab (TOC). All patients underwent baseline and follow-up PET/CT. The aorta and its major branches were assessed using PET vascular activity score (PETVAS) by independent readers. Cumulative glucocorticoid doses and cessation of glucocorticoid treatment were documented in all patients. Results We included 88 LV-GCA patients, 27 were treated with PRED, 42 with MTX, and 19 with TOC. PETVAS decreased from 18.9–8.0 units at follow-up in the overall population (p< 0.001). PETVAS changes were numerically higher in patients receiving MTX (-12.3 units) or TOC (-11.7 units) compared with PRED (-8.7). Mean cumulative prednisolone dosages were 5637, 4418, and 2984 mg in patients treated with PRED, MTX, and TOC (p= 0.002). Risk ratios for glucocorticoid discontinuation at the time of follow-up PET/CT were 6.77 (95%CI 1.01–45.29; p= 0.049) and 16.25 (95%CI 2.60–101.73; p= 0.003) for MTX and TOC users compared with PRED users. Conclusion Treatment of LV-GCA inhibits vascular inflammation in the aorta and its major branches. While similar control of vascular inflammation was achieved with PRED, MTX, and TOC treatments, TOC showed a strong glucocorticoid sparing effect, supporting the concept of initial combination therapy.

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PET/CT Imaging of Human TNFα Using [89Zr]Certolizumab Pegol in a Transgenic Preclinical Model of Rheumatoid Arthritis

Molecular Imaging and Biology ◽

10.1007/s11307-019-01363-0 ◽

2019 ◽

Vol 22 (1) ◽

pp. 105-114 ◽

Cited By ~ 4

Author(s):

Denis R. Beckford-Vera ◽

Alba Gonzalez-Junca ◽

Jessica S. Janneck ◽

Tony L. Huynh ◽

Joseph E. Blecha ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Certolizumab Pegol ◽

Ct Imaging ◽

Preclinical Model ◽

Pet Ct

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IMPROVEMENT IN LARGE DENSITY HDL PARTICLE NUMBER BY NMR IS ASSOCIATED WITH IMPROVEMENT IN VASCULAR INFLAMMATION BY 18-FDG PET/CT AT ONE-YEAR IN PSORIASIS

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(18)32229-0 ◽

2018 ◽

Vol 71 (11) ◽

pp. A1688 ◽

Cited By ~ 1

Author(s):

Amit Dey ◽

Martin Playford ◽

Aditya Joshi ◽

Agastya Belur ◽

Aditya Goyal ◽

...

Keyword(s):

Fdg Pet ◽

Particle Number ◽

Vascular Inflammation ◽

Large Density ◽

Pet Ct ◽

One Year ◽

Fdg Pet Ct

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Comparison of Bone Scintigraphy and PET/CT for the Evaluation of Disease Activity in Patients with Rheumatoid Arthritis: Application of Bone Scintigraphy

10.21203/rs.3.rs-138444/v1 ◽

2021 ◽

Author(s):

Sang Jin Lee ◽

Chae Moon Hong ◽

Il Cho ◽

Byeong-Cheol Ahn ◽

Jung Su Eun ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Bone Scintigraphy ◽

Clinical Assessment ◽

Tender Joint ◽

Positron Emission ◽

Pet Ct ◽

Active Arthritis ◽

Development Group ◽

Joint Assessment

Abstract Background: We aimed to compare the reliability of bone scintigraphy (BS) and fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)–derived parameters in the detection of active arthritis in 28-joint areas and evaluate the reliability of joint counts between BS and clinical assessment in patients with rheumatoid arthritis (RA). Methods: We enrolled 106 patients (67 in the development group and 39 in the validation groups) with active RA who underwent BS, 18F-FDG PET/computed tomography (CT), and clinical evaluation of disease activity. We compared the results of BS-derived joint assessment with those of PET-derived and clinical joint assessments. Subsequently we developed a disease activity score (DAS) using BS-positive joints and validated it in an independent group.Results: The number of BS-positive joints in 28-joint areas significantly correlated with the swollen /tender joint counts (SJC/TJC) and PET-derived joint counts. A BS uptake score of 2 (strong positive) was significantly more sensitive compared with a BS uptake score of 1 (weak positive) in detecting a PET-positive joint among the 28-joints. After conducting multivariate analyses including erythrocyte sediment rate (ESR) and patient global assessment (PGA) in addition to BS-derived parameters, BS/DAS was obtained as follows: 0.056 × number of BS-positive joints in 28 joints + 0.012 × ESR + 0.030 × PGA. A significant correlation between BS/DAS and DAS28-ESR was confirmed in the validation group. Conclusion: Strong positive uptake of BS is sensitive and reproducible for the detection of active joints, and can complement the clinical assessment of disease activity in RA.

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THU0440 Soluble ctla-4 is elevated in patients with polymyalgia rheumatica and correlates with vascular inflammation detected by pet/ct

10.1136/annrheumdis-2018-eular.4954 ◽

2018 ◽

Author(s):

D. Camellino ◽

M. Marchiano ◽

G. Pesce ◽

G. Bianchi ◽

M. Bagnasco ◽

...

Keyword(s):

Polymyalgia Rheumatica ◽

Vascular Inflammation ◽

Pet Ct

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Radionuclide imaging of arterial inflammation in HIV-infected patients with vascular atherosclerosis

Radiation Diagnostics, Radiation Therapy ◽

10.37336/2707-0700-2019-3-5 ◽

2019 ◽

pp. 45-57

Author(s):

Pavel Korol ◽

Oleg Shcherbina

Keyword(s):

Vascular Inflammation ◽

Key Words Atherosclerosis ◽

Infected People ◽

Positron Emission ◽

Pathogenic Factors ◽

Pet Ct ◽

Arterial Inflammation ◽

Fdg Pet Ct ◽

Preclinical And Clinical Studies

The review examined the role of arterial inflammation in atherogenesis and the pathogenic factors responsible for the high risk of cardiovascular diseases (CVD) among HIV-infected patients. Inflammation has been shown to play an important role in all phases of atherosclerotic CVD. HIV-infected patients have an increased tendency to CVD. The most effective radionuclide method of imaging the inflammatory process in the pathogenesis of CVD among HIV-infected people is F-18 FDG PET/CT. At the present stage, several ligands for visualization were synthesized, which were used to identify vascular inflammation in preclinical and clinical studies. These tracers, in addition to F-18 FDG, have significant potential for future use among HIV-infected patients. Key words: atherosclerosis, cardiovascular disease, positron emission tomography, HIV infection.

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Abstract 17414: Increased Activity of Brain Region Governing Stress Perception is Associated With Plaque Vulnerability and Vascular Inflammation in Acute Myocardial Infarction Population; Retrospective and Prospective Study Evaluated by 18 FDG-PET/CT and OCT

Circulation ◽

10.1161/circ.138.suppl_1.17414 ◽

2018 ◽

Vol 138 (Suppl_1) ◽

Author(s):

Eun Jin Park ◽

Jae Seon Eo ◽

Won-Young Jang ◽

Dong Oh Kang ◽

Cheol Ung Choi ◽

...

Keyword(s):

High Risk ◽

Prospective Study ◽

Fdg Pet ◽

Vascular Inflammation ◽

Syntax Score ◽

Plaque Vulnerability ◽

Coronary Syndrome ◽

Pet Ct ◽

Amygdala Activity ◽

Fdg Pet Ct

Backgrounds: Chronic mental stress is a major risk factor of coronary artery disease, but there is a lack of direct mechanistic evidence between brain amygdala activity, a neural stress center, versus plaque vulnerability in acute coronary syndrome. In this study, we aimed to evaluate whether brain amygdala activity in AMI patients assessed by 18 F-FDG PET/CT could be associated with vascular inflammation in carotid beds and high-risk coronary plaque features evaluated by OCT. Methods and Results: In retrospective analysis, the patients who underwent 18 F-FDG PET/CT and CAG at Korea University Guro Hospital (Seoul, Korea). Among 1802 patients underwent 18 F-FDG PET/CT from October 1 2009 to 31 December 31 2015, 230 patients received CAG. After excluding 36 patients who had active cancer or brain disease, 198 were stratified according to degree of coronary severity by syntax score [none (n=159); mild to moderate (n=26); severe (n=13)]. Brain amygdalar activity on PET was quantified as target-to-background ratio (TBR) of standardized uptake value (amygdalar SUV max /temporal SUV mean ). The amygdalar TBR was significantly higher in patients with severe coronary disease rather than those without coronary stenosis or mild to moderate stenosis assessed by syntax score (P=0.03). Intriguingly, among 13 patients with severe CAD, the amygdalar TBR significantly increased in the 6 patients presented as AMI compared to non-MI patients (P=0.03). In following prospective study, we performed 18 F-FDG PET/CT in AMI patients underwent percutaneous coronary intervention within index admission period, and in patients with chronic stable angina (CSA) as control. The plaque morphology in non-culprit segment of infarct-related artery (IRA) was estimated by OCT in AMI patients. Brain amygdalar TBR was significantly higher in AMI patients compared to CSA patients (p<0.05). In AMI patients, amygdalar activity was significantly associated with vascular inflammation quantified as carotid TBR (p<0.05). The increased amygdalar activity was associated with high-risk plaque characteristics of non-culprit segments of IRA. Conclusions: The amygdalar activity assessed by 18 F-FDG PET/CT was significantly higher in patients with AMI than CSA. This amygdalar activity was related to vulnerable plaque characteristics of IRA. Our results suggest that brain emotional activity in ACS could contribute to plaque instability in pan-vascular beds.

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Abstract 11890: S100A8/A9 is Increased in Psoriasis Serum, Relates to Vascular Diseases and Activates Human Endothelial Cells

Circulation ◽

10.1161/circ.132.suppl_3.11890 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Heather Teague ◽

Qimin Ng ◽

Monica Purmalek ◽

Balaji Natarajan ◽

Taufiq Salahuddin ◽

...

Keyword(s):

Endothelial Cells ◽

Fdg Pet ◽

Vascular Inflammation ◽

Vascular Diseases ◽

Aortic Endothelial Cells ◽

Pet Ct ◽

Calcified Plaque ◽

Fdg Pet Ct ◽

Psoriasis Severity

Introduction: Psoriasis is a chronic inflammatory disorder of the skin affecting 2-4% of the population and is associated with an increased risk of cardiovascular events, specifically myocardial infarction. Methods: In a large, ongoing prospective cohort study of psoriasis and cardiovascular diseases (NCT01778569), we studied a consecutive sample (n=100) and aimed to investigate the potential role that S100A8/A9 may have in linking psoriasis to CV disease measured by FDG PET CT and coronary CTA. Furthermore, we conducted in vitro experiments on human aortic endothelial cells (ECs) to examine whether treatement with S100A9 activates these cells. We hypothesized that S100A8/A9 would relate to psoriasis severity, relate to in vivo vascular inflammation by FDG PET CT, non-calcified burden of coronary disease by CCTA and increase endothelial cell activation. Results: We observed that the S100A8/A9 heterodimer was elevated in serum (mean psoriasis: 2019 ± 100.1; non-psoriasis: 1634 ± 160.7; p = 0.02), correlating both with psoriasis severity score (adjusted β = 0.53, p = 0.02) and overall aortic vascular inflammation measured by FDG PET CT (adjusted β = 0.48, p = 0.02) beyond the Framingham Risk Score. Additionally, we found that S100A8/A9 was associated with direct coronary atherosclerosis measured by coronary CTA demonstrating an increase in total (β = 0.16, p = 0.04) and non-calcified plaque burden (β = 0.23, p = 0.003) but not dense calcified burden. When EC's were treated with S100A9, ICAM1, E-Selectin and VCAM1 gene expression levels increased 10-fold (p = 0.001), 86-fold (P = 0.007) and 20-fold (p = 0.0002) respectively compared to the untreated human aortic endothelial cells. Conclusions: S100A8/A9 related to psoriasis severity, in vivo vascular inflammation, non-calcified plaque in the coronary arteries and EC activation. These findings suggest this protein may play a role in linking psoriasis to CVD and a role in early atherosclerotic plaque formation. Ongoing studies aim to elucidate the source of S100A8/A9 in the blood and to characterize the signaling pathway utilized by S100A8/A9 to understand whether this pathway is broadly applicable to vascular diseases associated with chronic inflammation.

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