High-frequency ultrasound in patients with seronegative rheumatoid arthritis

Wang, Junkui; Wang, Miao; Qi, Qinghua; Wu, Zhibin; Wen, Jianguo

doi:10.1038/s41598-022-25958-w

Cited by 4 publications

(2 citation statements)

References 42 publications

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“…Ultrasound is more accurate than clinical examination in detecting synovitis and has been shown to be able to help differentiate between seronegative RA and OA [81,82]. Standardised ultrasound scoring systems have been developed to facilitate its use in clinical trials [81], and some studies have compared US features between seropositive and seronegative RA.…”

Section: Ultrasoundmentioning

confidence: 99%

Clinical Phenotypes, Serological Biomarkers, and Synovial Features Defining Seropositive and Seronegative Rheumatoid Arthritis: A Literature Review

Perera,

Delrosso,

Nerviani

et al. 2024

Cells

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Rheumatoid arthritis (RA) is a chronic autoimmune disorder which can lead to long-term joint damage and significantly reduced quality of life if not promptly diagnosed and adequately treated. Despite significant advances in treatment, about 40% of patients with RA do not respond to individual pharmacological agents and up to 20% do not respond to any of the available medications. To address this large unmet clinical need, several recent studies have focussed on an in-depth histological and molecular characterisation of the synovial tissue to drive the application of precision medicine to RA. Currently, RA patients are clinically divided into “seropositive” or “seronegative” RA, depending on the presence of routinely checked antibodies. Recent work has suggested that over the last two decades, long-term outcomes have improved significantly in seropositive RA but not in seronegative RA. Here, we present up-to-date differences in epidemiology, clinical features, and serological biomarkers in seronegative versus seropositive RA and discuss how histological and molecular synovial signatures, revealed by recent large synovial biopsy-based clinical trials, may be exploited to refine the classification of RA patients, especially in the seronegative group.

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Section: Ultrasoundmentioning

confidence: 99%

Clinical Phenotypes, Serological Biomarkers, and Synovial Features Defining Seropositive and Seronegative Rheumatoid Arthritis: A Literature Review

Perera,

Delrosso,

Nerviani

et al. 2024

Cells

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show abstract

“…;Ju et al, 2020;Zhao and Hao, 2018;Li and WH, 2020; Xu YM. et al, 2015;Chen et al, 2018;Zhao et al, 2017a;Deng, 2017;Xie et al, 2018;Rao et al, 2014;Wang et al, 2022;Dai et al, 2022;Sun and Li, 2022;Wu et al, 2022;Dong Zhang et al, 2019;Qiu et al, 2016;Yuan et al, 2020;Pang et al, 2020;Lin et al, 2019;Xu et al, 2019;Zeng et al, 2016;Bai et al, 2021;Li X. et al, 2021;Gu, 2020;Jiang et al, 2014;Zhao, 2019;Lu and Zhang, 2021;Zhang, 2019;Jia, 2020;Yu, 2020;Shao et al, 2020;Chen et al, 2022;Donghui, 2019;Zhang and Shen, 2019;Jiang et al, 2016; Xie H. et al, 2020;Jiang et al, 2020;Bai and Jiao, 2019;Rao et al, 2022;Ding et al, 2022; Xu D. et al, 2017; Luo Q. et al, 2018;Wang Y. et al, 2019;Zhao, 2020;Liang et al, 2021;Li et al, 2018;Jiang, 2021;…”

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Efficacy and safety of iguratimod in the treatment of rheumatic and autoimmune diseases: a meta-analysis and systematic review of 84 randomized controlled trials

Zeng,

He,

Deng

et al. 2023

Front. Pharmacol.

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Objective: To evaluate efficacy and safety of iguratimod (IGU) in the treatment of rheumatic and autoimmune diseases.Methods: Databases such as Pubmed, Embase, Sinomed were searched (as of July 2022) to collect randomized controlled trials (RCTs) of IGU in the treatment of rheumatic and autoimmune diseases. Two researchers independently screened the literature, extracted data, assessed the risk of bias of the included literature, and performed meta-analysis using RevMan 5.4 software.Results: A total of 84 RCTs and 4 types of rheumatic and autoimmune diseases [rheumatoid arthritis (RA), ankylosing spondylitis (AS), primary Sjögren’s syndrome (PSS) and Autoimmune disease with interstitial pneumonia]. Forty-three RCTs reported RA and showed that IGU + MTX therapy can improve ACR20 (RR 1.45 [1.14, 1.84], p = 0.003), ACR50 (RR 1.80 [1.43, 2.26], p < 0.0000), ACR70 (RR 1.84 [1.27, 2.67], p = 0.001), DAS28 (WMD −1.11 [−1.69, −0.52], p = 0.0002), reduce ESR (WMD −11.05 [−14.58, −7.51], p < 0.00001), CRP (SMD −1.52 [−2.02, −1.02], p < 0.00001), RF (SMD −1.65 [−2.48, −0.82], p < 0.0001), and have a lower incidence of adverse events (RR 0.84 [0.78, 0.91], p < 0.00001) than the control group. Nine RCTs reported AS and showed that IGU can decrease the BASDAI score (SMD −1.62 [−2.20, −1.05], p < 0.00001), BASFI score (WMD −1.07 [−1.39, −0.75], p < 0.00001), VAS (WMD −2.01 [−2.83, −1.19], p < 0.00001), inflammation levels (decreasing ESR, CRP and TNF-α). Thirty-two RCTs reported PSS and showed that IGU can reduce the ESSPRI score (IGU + other therapy group: WMD −1.71 [−2.44, −0.98], p < 0.00001; IGU only group: WMD −2.10 [−2.40, −1.81], p < 0.00001) and ESSDAI score (IGU + other therapy group: WMD −1.62 [−2.30, −0.94], p < 0.00001; IGU only group: WMD −1.51 [−1.65, −1.37], p < 0.00001), inhibit the inflammation factors (reduce ESR, CRP and RF) and increase Schirmer’s test score (IGU + other therapy group: WMD 2.18 [1.76, 2.59], p < 0.00001; IGU only group: WMD 1.55 [0.35, 2.75], p = 0.01); The incidence of adverse events in IGU group was also lower than that in control group (IGU only group: RR 0.66 [0.48, 0.98], p = 0.01). Three RCTs reported Autoimmune disease with interstitial pneumonia and showed that IGU may improve lung function.Conclusion: Based on current evidence, IGU may be a safe and effective therapy for RA, AS, PSS and autoimmune diseases with interstitial pneumonia.Systematic Review Registration: (CRD42021289489).

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Contribution of Musculoskeletal Ultrasound in the Diagnosis of Seronegative Rheumatoid Arthritis

Cen,

He,

Wang

et al. 2024

J of Ultrasound Medicine

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ObjectiveThis is a study to investigate the value of musculoskeletal ultrasound for the early diagnosis of seronegative rheumatoid arthritis (SNRA); and to study the relationship between anti‐cyclic citrullinated peptide antibody (anti‐CCP) and the occurrence of bone erosion in rheumatoid arthritis (RA) detected by ultrasound.MethodsA total of 101 patients with RA or osteoarthritis (OA) admitted to the First Affiliated Hospital of Anhui Medical University from July 2022 to December 2023 were selected and divided into the SNRA group, the SPRA group, and the OA group. The patients' metacarpophalangeal joints, proximal interphalangeal joints, distal interphalangeal joints, and wrist joints of both hands were ultrasonically examined separately, and the extensor tendon, flexor tendon, synovium, joint surface, joint cavity, and bone surface were observed.ResultsThe differences in the detection of joint effusion, bone erosion, and joint space narrowing were not statistically significant between SNRA group and OA group (P > .05), the differences in the detection of synovitis and tenosynovitis were statistically significant (P < .05). The mean levels of synovial hyperplasia grade and synovial blood flow grade between SNRA group and OA group were significantly different (P < .05). The differences in synovitis, tenosynovitis, joint effusion, and joint space narrowing were not statistically significant between SNRA and SPRA groups (P > .05), and the differences in bone erosion were statistically significant (P < .05). The mean levels of synovial hyperplasia grade and synovial blood flow grade between SNRA group and SPRA group were significantly different (P < .05). Logistic regression analysis showed that anti‐CCP antibody was an influential factor for bone erosion in RA patients (P < .05). The ROC curve was plotted, and the optimal cut‐off value of anti‐CCP antibody was 356.5 U/mL, at which time the AUC was 0.716, the sensitivity of diagnosing bone erosion was 0.714, the specificity was 0.694, and the Yoden index was 0.408.ConclusionIn summary, ultrasound is helpful for the early diagnosis of SNRA by evaluating the condition of joints, synovium, and tendon sheath, and when anti‐CCP antibodies are positive, ultrasound is more likely to detect bone erosion. Ultrasound examination combined with anti‐CCP antibody can further observe the joint lesions.

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High-frequency ultrasound in patients with seronegative rheumatoid arthritis

Cited by 4 publications

References 42 publications

Clinical Phenotypes, Serological Biomarkers, and Synovial Features Defining Seropositive and Seronegative Rheumatoid Arthritis: A Literature Review

Clinical Phenotypes, Serological Biomarkers, and Synovial Features Defining Seropositive and Seronegative Rheumatoid Arthritis: A Literature Review

Efficacy and safety of iguratimod in the treatment of rheumatic and autoimmune diseases: a meta-analysis and systematic review of 84 randomized controlled trials

Contribution of Musculoskeletal Ultrasound in the Diagnosis of Seronegative Rheumatoid Arthritis

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