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Predictive value of bone destruction and duration of clinical remission for subclinical synovitis in rheumatoid arthritis patients.
- Source :
-
Modern rheumatology [Mod Rheumatol] 2015 Jul; Vol. 25 (4), pp. 540-5. Date of Electronic Publication: 2014 Dec 15. - Publication Year :
- 2015
-
Abstract
- Objectives: Treatment for rheumatoid arthritis (RA) should aim to achieve full remission. The aim of this study was to investigate predictors of persistent subclinical synovitis and whether longer clinical remission is effective in reducing subclinical synovitis.<br />Methods: Forty-four RA patients who achieved DAS28ESR clinical remission for at least 3 months were enrolled in this study and underwent ultrasound examination of 22 joints (bilateral proximal interphalangeal joints, metacarpophalangeal joints, and wrists); bilateral hand X-ray; and blood examination. The severity of synovial effusion, synovial hypertrophy, and blood flow were semi-quantitatively graded from 0 to 3 using gray-scale (GS) and power Doppler (PD) modes.<br />Results: Among patients with DAS28ESR-defined clinical remission, 59.1% (26/44) demonstrated residual synovitis (≥ PD1) in at least one joint. Genant-modified total Sharp score (TSS) demonstrated the highest statistical difference between patients with and without residual subclinical synovitis (p = 0.0057), and full remission was only observed in patients with low TSS. A nonsignificant trend for decreased residual synovitis with longer sustained clinical remission was also observed (p = 0.724).<br />Conclusion: Residual synovitis can persist during clinical remission, particularly in patients with progressive bone destruction. Early treatment and longer sustained clinical remission prior to bone destruction are critical for full remission.
- Subjects :
- Adult
Aged
Arthritis, Rheumatoid drug therapy
Female
Follow-Up Studies
Humans
Male
Middle Aged
Predictive Value of Tests
Remission Induction methods
Synovitis etiology
Ultrasonography, Doppler
Young Adult
Arthritis, Rheumatoid diagnostic imaging
Metacarpophalangeal Joint diagnostic imaging
Synovitis diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1439-7609
- Volume :
- 25
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Modern rheumatology
- Publication Type :
- Academic Journal
- Accession number :
- 25496404
- Full Text :
- https://doi.org/10.3109/14397595.2014.987421