Persistence of ultrasound synovitis in patients with rheumatoid arthritis fulfilling the DAS28 and/or the new ACR/EULAR RA remission definitions: results of an observational cohort study.

Zufferey, Pascal; Möller, Burkhard; Brulhart, Laure; Tamborrini, Giorgio; Scherer, Almut; Finckh, Axel; Ziswiler, Hans Rudolf (2014). Persistence of ultrasound synovitis in patients with rheumatoid arthritis fulfilling the DAS28 and/or the new ACR/EULAR RA remission definitions: results of an observational cohort study. Joint bone spine, 81(5), pp. 426-432. Elsevier Masson SAS 10.1016/j.jbspin.2014.04.014

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OBJECTIVE The primary aim of the study was to evaluate whether rheumatoid arthritis (RA) patients considered to be in remission according to clinical criteria sets still had persisting ultrasound (US) synovitis. We further intended to evaluate the capacity of our US score to discriminate between the patients with a clinically active disease versus those in remission. METHODS This is an observational study nested within the Swiss Clinical Quality Management in Rheumatic Diseases (SCQM) rheumatoid arthritis cohort. A validated US score (SONAR score) based on a semi-quantitative B-mode and Doppler (PwD) score as part of the regular clinical workup by rheumatologists in different clinical settings was used. To define clinically relevant synovitis, the same score was applied to 38 healthy controls and the 90st percentile was used as cut-off for 'relevant' synovitis. RESULTS Three hundred and seven patients had at least one US examination and concomitant clinical information on disease activity. More than a third of patients in both DAS28 and ACR/EULAR remission showed significant gray scale synovitis (P=0.01 and 0.0002, respectively) and PwD activity (P=0.005 and 0.0005, respectively) when compared to controls. The capacity of US to discriminate between the two clinical remission groups and patients with active disease was only moderate. CONCLUSION This observational study confirms that many patients considered to be in clinical remission according the DAS and the ACR/EULAR definitions still have residual synovitis on US. The prognostic significance of US synovitis and the exact place of US in patients reaching clinical remission need to be further evaluated.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology, Clinical Immunology and Allergology

UniBE Contributor:

Möller, Burkhard and Ziswiler, Hans Rudolf

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1297-319X

Publisher:

Elsevier Masson SAS

Language:

English

Submitter:

Stefan Kuchen

Date Deposited:

06 Mar 2015 14:40

Last Modified:

06 Nov 2015 09:18

Publisher DOI:

10.1016/j.jbspin.2014.04.014

PubMed ID:

24956986

Uncontrolled Keywords:

Remission, Rheumatoid arthritis, Score, US

BORIS DOI:

10.7892/boris.64158

URI:

https://boris.unibe.ch/id/eprint/64158

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