Rheumatoid Arthritis Clinical Trial
Atlantoaxial subluxation (AAS) is a complication of rheumatoid arthritis (RA) due to pannus
formation around the odontoid process of C2 of the cervical spine. It occurs frequently in
15-30% of all RA patients. AAS may occur relatively early in the course of disease within
the first years. The diagnosis of AAS identifies a patient population with a poor outcome.
There is evidence that combination treatment with disease-modifying anti-rheumatic drugs
(DMARD) may retard the development of AAS. However, it is not known whether treatment with
inhibitors of tumor necrosis factor alpha (TNF) may lead to regression of cervical pannus
and prevention or reduction of AAS.
Clinical studies analysing the effectiveness of TNF-inhibitors combined with conventional
DMARD therapy, in the treatment of cervical spine involvement leading to AAS, are needed.
This proposal for a pilot study aims at assessing the feasibility of an MRI-based
measurement of pannus volume in patients before and after treatment with a TNF-inhibitor.
Primary objective: To show that measurements of pannus mass with MRI is feasible. Secondary
objective: To assess whether pannus mass decreases measurably in patients treated with
TNF-inhibitors.
This pilot study is prospective, non-randomized. The choice of therapy at any time during
the study is entirely up to the treating rheumatologist.
n/a
Observational Model: Case-Only, Time Perspective: Prospective
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