Responsiveness in Rheumatoid Arthritis. A Report from the OMERACT 11 Ultrasound Workshop

Abstract

Objective. To summarize the work performed by the Outcome Measures in Rheumatology (OMERACT) Ultrasound (US) Task Force on the validity of different US measures in rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA) presented during the OMERACT 11 Workshop. Methods. The Task Force is an international group aiming to iteratively improve the role of US in arthritis clinical trials. Recently a major focus of the group has been the assessment of responsiveness of a person-level US synovitis score in RA: the US Global Synovitis Score (US-GLOSS) combines synovial hypertrophy and power Doppler signal in a composite score detected at joint level. Work has also commenced examining assessment of tenosynovitis in RA and the role of US in JIA Results. The US-GLOSS was tested in a large RA cohort treated with biologic therapy. It showed early signs of improvement in synovitis starting at Day 7 and increasing to Month 6, and demonstrated sensitivity to change of the proposed grading. Subsequent voting questions concerning the application of the US-GLOSS were endorsed by > 80% of OMERACT delegates. A standardized US scoring system for detecting and grading severity of RA tenosynovitis and tendon damage has been developed, and acceptable reliability data were presented from a series of exercises. A preliminary consensus definition of US synovitis in pediatric arthritis has been developed and requires further testing. Conclusion. At OMERACT 11, consensus was achieved on the application of the US-GLOSS for evaluating synovitis in RA; and work continues on development of RA tenosynovitis scales as well as in JIA synovitis

How does a cadaver model work for testing ultrasound diagnostic capability for rheumatic-like tendon damage?

“…Over the last decade, the OMERACT MSUS group has assessed the metric properties of US in detecting and scoring potential endpoint in rheumatic diseases for clinical trials and practice [24][25][26][27][28]. The group has worked on validation of US-detected and graded tendon damage in RA [19,20], which is an essential component of the structural damage in this disease [19,20].…”

The use of musculoskeletal ultrasound in a Rheumatology Outpatient Clinic

“…The results, indicating that RA was the most frequent indication for US assessment, underline the great interest of rheumatologists for this condition: data from the literature indicate the growing interest on the US application in patients affected by RA [9][10][11][12][13]. Thanks to its great sensitivity in detecting abnormalities since early phase of disease and in identifying subclinical synovitis, US assessment is recommended as a complementary tool to the clinical evaluation [14].…”

Strategy for Dose Reduction and Discontinuation of Biological Agents in Rheumatoid Arthritis Remission

“…На конференции, посвященной применению ультра-звуковых методов исследования при РА, большинство уча-стников высказались за комбинированную оценку сустав-ной патологии с использованием серой шкалы и ЭД для выявления воспалительных изменений суставов [42,43]. В настоящее время нет единого подхода при изучении пре-дикторной значимости инструментальных признаков си-новита при РА [44].…”