Synovitis in rheumatoid arthritis detected by grey scale ultrasound predicts the development of erosions over the next three years.
Aged
Antirheumatic Agents
/ therapeutic use
Arthritis, Rheumatoid
/ diagnostic imaging
Disease Progression
Female
Finger Joint
/ diagnostic imaging
Hand Bones
/ diagnostic imaging
Humans
Male
Middle Aged
Prognosis
Radiography
Synovitis
/ diagnostic imaging
Ultrasonography
Ultrasonography, Doppler
Wrist Joint
/ diagnostic imaging
biological therapies
hand
rheumatoid arthritis
synovium
ultrasonography
Journal
Rheumatology (Oxford, England)
ISSN: 1462-0332
Titre abrégé: Rheumatology (Oxford)
Pays: England
ID NLM: 100883501
Informations de publication
Date de publication:
01 07 2020
01 07 2020
Historique:
received:
30
05
2019
revised:
30
07
2019
pubmed:
21
10
2019
medline:
6
10
2020
entrez:
21
10
2019
Statut:
ppublish
Résumé
To evaluate grey scale US (GSUS) and power Doppler US synovitis (PDUS), separately or in combination (CombUS), to predict joint damage progression in RA. In this cohort study nested in the Swiss RA register, all patients with sequential hand radiographs at their first US assessment were included. We analysed the summations of semi-quantitative GSUS, PDUS and CombUS assessments of both wrists and 16 finger joints (maximum 54 points) at their upper limit of normal, their 50th, 75th or 87.5th percentiles for the progression of joint damage (ΔXray). We adjusted for clinical disease activity measures at baseline, the use of biological DMARDs and other confounders. After a median of 35 months, 69 of 250 patients with CombUS (28%), 73 of 259 patients with PDUS (28%) and 75 of 287 patients with available GSUS data (26%) demonstrated joint damage progression. PDUS beyond upper limit of normal (1/54), GSUS and CombUS each at their 50th (9/54 and 10/54) and their 75th percentiles (14/54 and 15/54) were significantly associated with ΔXray in crude and adjusted models. In subgroup analyses, GSUS beyond 14/54 and CombUS higher than 15/54 remained significantly associated with ΔXray in patients on biological DMARDs, while clinical disease activity measures had no significant prognostic power in this subgroup. Higher levels of GSUS and CombUS are associated with the development of erosions. GSUS appears to be an essential component of synovitis assessment and an independent predictor of joint damage progression in patients on biological DMARDs.
Identifiants
pubmed: 31630207
pii: 5599875
doi: 10.1093/rheumatology/kez460
pmc: PMC7310093
doi:
Substances chimiques
Antirheumatic Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1556-1565Informations de copyright
© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Rheumatology.
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