AB0396 MONITORING OF PATIENTS WITH RHEUMATOID ARTHRITIS BY INDOCYANINE GREEN (ICG) ENHANCED FLUORESCENCE OPTICAL IMAGING TREATED WITH ANTI-TNFI THERAPY
Authors: Simon Hertrampf, Jens Klotsche, Querino Schefer, Anne-Marie Glimm, Gerd Rüdiger Burmester, Gabriela Schmittat, Thomas HÄupl, Sandra Hermann, Marina Backhaus, Sarah Ohrndorf
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Indocyanine (ICG)-enhanced fluorescence optical imaging (FOI) by the Xiralite® system enables visualization of inflammation in the hands in rheumatic joint diseases. <h3>Objectives</h3> To investigate the ability of monitoring treatment response under Certolizumab pegol (CZP) in patients with rheumatoid arthritis (RA) by the ICG-enhanced FOI method Xiralite® as compared to clinical disease activity, laboratory parameters, and musculoskeletal ultrasound (US). <h3>Methods</h3> CZP-naive patients with RA were eligible for this study, which consisted of an open-label 52-weeks treatment period with CZP. Disease activity was monitored by the clinical score DAS28, laboratory parameters for systemic inflammation (CRP and ESR), ultrasonography (US7 score [1]) and by FOI at baseline (before CZP) and after 6, 12, 24, and 52 weeks under CZP therapy. <h3>Results</h3> In this study, 28 patients (female 92.9%, mean age 49.4±13.3) with RA were included and treated with CZP over a period of 52 weeks. All patients received CZP for at least 12 weeks (w), n=27 until w24, and n=18 received CZP throughout the entire 52 weeks. DAS28 decreased from moderate disease activity (median 4.6) at baseline to low disease activity (median 2.7) at w52 (p &lt;0.001). CRP/ESR values also reduced from baseline to w52 (n.s.). FOI in phase 1 showed a continuous decrease of enhancement during the course of the treatment period: from baseline (median 1.5, IQR 0-9.5) to w6 (median 1.0, IQR 0-3), to w12 (median 0.5, IQR 0-3), to w24 (median 0.0, IQR 0-3) and visit w52 (median 0.0, IQR 0-2). An image example is given by the <b>Figure</b> for baseline and w52. The results for other FOI phases 2, 3 and PVM did not show a decrease over the treatment period. US-detected synovitis and tenosynovitis by the US7 score also presented to be responsive under therapy. Especially US7-synovitis in Power Doppler (PD) was reduced from baseline (median 2.0, IQR 1-4) to w52 (median 0.5, IQR 0-2). <h3>Conclusion</h3> FOI in phase 1 appears to be a valuable tool for fast and easy monitoring of treatment response to CZP in a clinical setting. FOI may provide an additional method to evaluate inflammation of wrist and finger joints of RA patients in follow-up studies. <h3>References</h3> [1] Backhaus M, Ohrndorf S, Kellner H, et al. Evaluation of a novel 7-joint ultrasound score in daily rheumatologic practice: a pilot project. Arthritis Rheum. 2009;61(9):1194-201 <h3>Legend</h3> ICG: indocyanine green; FOI: fluorescence optical imaging; CZP: Certolizumab pegol; w52: week 52 <h3>Acknowledgement</h3> UCB Pharma GmbH provided financial support of this study. UCB Pharma GmbH did not have any influence on the statistical analysis or preparation of the abstract. This study was also supported by the Bundesministerium für Bildung und Forschung (BMBF) project "ArthroMark", subproject no. 7. <h3>Disclosure of Interests</h3> Simon Hertrampf: None declared, Jens Klotsche: None declared, Querino Schefer: None declared, Anne-Marie Glimm: None declared, Gerd Rüdiger Burmester Consultant for: Roche, Sanofi-Genzyme, Speakers bureau: Roche, Sanofi-Genzyme, Gabriela Schmittat: None declared, Thomas HÄupl: None declared, Sandra Hermann: None declared, Marina Backhaus: None declared, Sarah Ohrndorf: None declared