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The predictive role of ultrasound-detected tenosynovitis and joint synovitis for flare in patients with rheumatoid arthritis in stable remission. Results of an Italian multicentre study of the Italian Society for Rheumatology Group for Ultrasound: The STARTER study
- Publication Year :
- 2018
-
Abstract
- ObjectiveTo define the role of ultrasound (US) for the assessment of patients with rheumatoid arthritis (RA) in clinical remission, including joint and tendon evaluation.MethodsA multicentre longitudinal study has been promoted by the US Study Group of the Italian Society for Rheumatology. 25 Italian centres participated, enrolling consecutive patients with RA in clinical remission. All patients underwent complete clinical assessment (demographic data, disease characteristics, laboratory exams, clinical assessment of 28 joints and patient/physician-reported outcomes) and Power Doppler (PD) US evaluation of wrist, metacarpalphalangeal joints, proximal interphalangeal joints and synovial tendons of the hands and wrists at enrolment, 6 and 12 months. The association between clinical and US variables with flare, disability and radiographic progression was evaluated by univariable and adjusted logistic regression models.Results361 patients were enrolled, the mean age was 56.20 (±13.31) years and 261 were women, with a mean disease duration of 9.75 (±8.07) years. In the 12 months follow-up, 98/326 (30.1%) patients presented a disease flare. The concurrent presence of PD positive tenosynovitis and joint synovitis predicted disease flare, with an OR (95% CI) of 2.75 (1.45 to 5.20) in crude analyses and 2.09 (1.06 to 4.13) in adjusted analyses. US variables did not predict the worsening of function or radiographic progression. US was able to predict flare at 12 months but not at 6 months.ConclusionsPD positivity in tendons and joints is an independent risk factor of flare in patients with RA in clinical remission. Musculoskeletal ultrasound evaluation is a valuable tool to monitor and help decision making in patients with RA in clinical remission.
- Subjects :
- Male
Wrist Joint
Genetics and Molecular Biology (all)
rheumatoid arthritis
Longitudinal study
Wrist
Severity of Illness Index
Biochemistry
Arthritis, Rheumatoid
0302 clinical medicine
Recurrence
Risk Factors
Immunology and Allergy
030212 general & internal medicine
Longitudinal Studies
Synovitis
treatment
Remission Induction
ultrasonography
Middle Aged
Prognosis
medicine.anatomical_structure
Italy
Rheumatoid arthritis
Female
Adult
medicine.medical_specialty
Hand Joints
Immunology
disease activity
General Biochemistry, Genetics and Molecular Biology
NO
Rheumatology
03 medical and health sciences
Internal medicine
medicine
Humans
Risk factor
Aged
Biochemistry, Genetics and Molecular Biology (all)
030203 arthritis & rheumatology
Tenosynovitis
business.industry
Ultrasonography, Doppler
rheumatoid arthriti
medicine.disease
Interphalangeal Joint
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....299adb98c33065482ad240c4b14af196