Back to Search
Start Over
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.
- Source :
-
Annals of the rheumatic diseases [Ann Rheum Dis] 2018 Sep; Vol. 77 (9), pp. 1283-1289. Date of Electronic Publication: 2018 Jun 09. - Publication Year :
- 2018
-
Abstract
- Objective: To define the role of ultrasound (US) for the assessment of patients with rheumatoid arthritis (RA) in clinical remission, including joint and tendon evaluation.<br />Methods: A 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.<br />Results: 361 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.<br />Conclusions: PD 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.<br />Competing Interests: Competing interests: None required.<br /> (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
- Subjects :
- Adult
Aged
Arthritis, Rheumatoid complications
Arthritis, Rheumatoid epidemiology
Female
Hand Joints diagnostic imaging
Humans
Italy epidemiology
Longitudinal Studies
Male
Middle Aged
Prognosis
Recurrence
Remission Induction
Risk Factors
Severity of Illness Index
Synovitis epidemiology
Synovitis etiology
Tenosynovitis epidemiology
Tenosynovitis etiology
Ultrasonography, Doppler methods
Wrist Joint diagnostic imaging
Arthritis, Rheumatoid diagnostic imaging
Synovitis diagnostic imaging
Tenosynovitis diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1468-2060
- Volume :
- 77
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Annals of the rheumatic diseases
- Publication Type :
- Academic Journal
- Accession number :
- 29886430
- Full Text :
- https://doi.org/10.1136/annrheumdis-2018-213217