Factors influencing ultrasonographic remission in patients with rheumatoid arthritis

Abstract

The aim of this study was to define the ultrasonographic factors that indicate clinical remission in patients with RA. We enrolled a cohort of patients with RA in whom the disease had been in remission for at least 6 months. Musculoskeletal ultrasound (US) examination was used to evaluate the status of active synovitis, power Doppler (PD) signalling, and synovitis in the bilateral metacarpophalangeal; proximal interphalangeal; and radiocarpal, ulnocarpal, and intercarpal, compartments of the wrist. A total of 64 RA patients with a mean disease duration of 79.97 months were studied. Of all patients, 36% had ultrasonographic synovitis and 29% an increased PD signal from at least one joint. Delay in diagnosis was highly correlated with synovitis and PD synovitis (r = 0.55, p = 0.000; and r = 0.51, p = 0.001, respectively). A weak negative correlation was evident between synovitis, PD synovitis, tenosynovitis, PD tenosynovitis, and duration of clinical remission (respectively, r = -0.426, p = 0.000; r = -0.333, p = 0.007; r = -0.243, p = 0.050; and r = -0.247, p = 0.049). Upon multivariate logistic regression analysis, the duration of clinical remission and delay in diagnosis were the factors that most influenced ultrasonographic remission (OR 3.46, p = 0.046; OR 3.27, p = 0.016, respectively). Synovial inflammation may persist in RA patients exhibiting clinical remission. We found that US detected subclinical synovitis. The most important factors preventing ultrasonographic remission were a short duration of clinical remission and delay in diagnosis.

High frequency ultrasonography of the hand versus anti-RA33 evaluation in early rheumatoid arthritis - a pilot study

“…Analysing US findings, we found a moderately positive correlation, but not statistically significant, between the initial titre of anti-CCP antibodies and the presence of active synovitis, after 12 months of treatment. A similar observation was noted by Harman et al [1].…”

“…Setting an antibody profile, highly specific and sensitive, with a diagnostic and prognostic value, could be essential for assessing remission [1,[22][23][24][25][26]. Besides anti-CCP antibodies, present very early in the course of the disease, anti-RA33 antibodies can constitute an additional marker, not only for improving diagnosis, but also for assessing the prognosis and therapeutic response [5,27,28].…”

“…In rheumatoid arthritis (RA) an early diagnosis is essential for an optimal management of the disease [1], with a real impact on the patients' quality of life [2]. An accurate diagnosis encloses to identify antibodies with high specificity and sensitivity for both diagnostic and prognostic purpose [2].…”

Place de l’échographie dans la polyarthrite rhumatoïde en rémission

“…Il est noté une tendance à la corrélation entre les données échographiques et histologiques. Dans l'étude de Harman et al [33], le délai diagnostique est fortement corrélé avec la persistance d'une synovite en mode B et Doppler (r = 0,55, p = 0,0001 ; et r = 0,51, p = 0,001, respectivement), tandis qu'une corrélation négative est trouvée entre la persistance d'une synovite en mode B et Doppler, d'une ténosy-novite en mode B et Doppler et la durée de la rémission clinique (r = −0,426, p = 0,0001 ; r = −0,333, p = 0,007 ; r = −0,243, p = 0,050 ; et r = −0,247, p = 0,049 respectivement). En analyse multivariée, la durée de la rémission clinique et le délai diagnostique sont les 2 facteurs qui influencent le plus la rémission échographique (OR 3,46 ; p = 0,046 et OR 3,27 ; p = 0,016, respectivement).…”

Association Between Clinical Manifestations and Ultrasonic Signs of Inflammation in Patients With Rheumatoid Arthritis

“…В то же время, по результатам исследования Н. Harman и соавт. [26], не было вы-явлено связи между активностью си-новита по данным УЗИ, уровнем СРБ и СОЭ. E. Filippucci и соавт.…”