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Deep clinical remission: an optimised target in the management of rheumatoid arthritis? Experience from an ultrasonography study
Y. Geng1, J. Han2, X. Deng3, Z. Zhang4
- Department of Rheumatology and Clinical Immunology, Peking University First Hospital, Beijing, China.
- Department of Rheumatology and Clinical Immunology, Peking University First Hospital, Beijing, China.
- Department of Rheumatology and Clinical Immunology, Peking University First Hospital, Beijing, China.
- Department of Rheumatology and Clinical Immunology, Peking University First Hospital, Beijing, China. zhuoli.zhang@126.com
CER8800
2016 Vol.34, N°4
PI 0581, PF 0586
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PMID: 27050636 [PubMed]
Received: 19/06/2015
Accepted : 07/01/2016
In Press: 06/04/2016
Published: 14/07/2016
Abstract
OBJECTIVES:
Treat-to-target strategy, aiming at clinical remission, has greatly improved the prognosis of RA. However, ultrasonographic subclinical synovitis is correlated with bone erosion and disease flare. The aim of this study was to evaluate whether deeper clinical remission (DAS28(ESR)≤1.98) reflects the better control of subclinical synovitis.
METHODS:
One hundred and twenty-six RA patients in clinical remission were enrolled in the study. Disease activity and ultrasongraphy were evaluated at baseline, and every 3 months during a 12-month follow-up. The power Doppler (PD) synovitis and synovial hypertrophy (SH) of 22 joints were recorded semi-quantitatively. The relationship between the extent of clinical remission, flare and ultrasonographic features was analysed.
RESULTS:
In 126 RA patients, 76 achieved deep clinical remission (defined as DAS28(ESR)≤1.98) and 50 achieved mild clinical remission (defined as 1.98
Subclinical synovitis was common in RA patients even in deep clinical remission. The deeper the clinical remission, the milder the subclinical synovitis, and the lower risk to relapse. Therefore, achieving deeper clinical remission, which reflected better control of subclinical synovitis and less tendency to flare, could be an optimised treatment target of RA.
