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Ultrasound versus clinical remission in patients with early rheumatoid arthritis: concordance and relationship with therapy discontinuation

1, 2, 3, 4, 5, 6, 7, 8

 

  1. UOC di Reumatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, and Università Cattolica del Sacro Cuore, Rome, Italy.
  2. UOC di Reumatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, and Università Cattolica del Sacro Cuore, Rome, Italy.
  3. UOC di Reumatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, and Università Cattolica del Sacro Cuore, Rome, Italy.
  4. UOC di Reumatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, and Università Cattolica del Sacro Cuore, Rome, Italy.
  5. UOC di Reumatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  6. UOC di Reumatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  7. UOC di Reumatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, and Università Cattolica del Sacro Cuore, Rome, Italy.
  8. UOC di Reumatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. augusta.ortolan@yahoo.it

CER17290
2024 Vol.42, N°11
PI 2159, PF 2166
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PMID: 39436716 [PubMed]

Received: 12/11/2023
Accepted : 17/04/2024
In Press: 15/10/2024
Published: 04/11/2024

Abstract

OBJECTIVES:
To evaluate prevalence of ultrasonographic remission (USR) and concordance with clinical remission in “drug-free” or “on-treatment” patients with early rheumatoid arthritis (RA).
METHODS:
We carried out a cross-sectional study including consecutive early RA patients in SDAI remission ≥6 months in the period 06/2022 to 02/2023. CDAI, DAS28, DAS44 and Boolean remission were also evaluated. Patients underwent B-mode and Power Doppler (PD) assessments of 42 joints and 20 tendons. Synovitis, tenosynovitis and PD were graded semi-quantitatively (0–3) using standardised scores. Four definitions of USR were examined: USR1: absence of synovial hypertrophy (SH) and PD; USR2: SH≤1 and PD=0; USR3: SH≤1 and PD≤1; USR4: PD negative.
RESULTS:
Eighty patients were enrolled, of whom 12 drug-free. Overall remission rates were 100.0%, 83.7%, 91.2%, 96.2% and 80.0% for SDAI, CDIA, DAS28, DAS44 and ACR/EULAR Boolean criteria, respectively. 100% of drug-free patients were in remission according to all indices. The rate of USR in drug-free versus on-treatment remission was 58.3%, 66.7%, 66.7%, 83.3% versus 70.6%, 85.3%, 88.2%, 91.2% for USR1, USR2, USR3 and USR4, respectively.
CONCLUSIONS:
While clinical remission seems more frequent in drug-free patients, USR is more often observed on-treatment.

DOI: https://doi.org/10.55563/clinexprheumatol/mf8sub

Rheumatology Article