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

IF 3.4 4区 医学 Q2 RHEUMATOLOGY
Raffaele La Ferrara, Federico Giuseppe Lazzaro, Gabriella Alonzi, Silvia Fiore, Giusy Peluso, Anna Laura Fedele, Maria Antonietta D'Agostino, Augusta Ortolan
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引用次数: 0

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.

早期类风湿性关节炎患者的超声与临床缓解:一致性以及与停止治疗的关系。
目的评估 "无药 "或 "正在治疗 "的早期类风湿关节炎(RA)患者的超声缓解(USR)发生率以及与临床缓解的一致性:我们进行了一项横断面研究,包括2022年6月至2023年2月期间SDAI缓解≥6个月的连续早期RA患者。同时还对 CDAI、DAS28、DAS44 和布尔缓解进行了评估。对患者的 42 个关节和 20 条肌腱进行了 B 型和功率多普勒(PD)评估。使用标准化评分对滑膜炎、腱鞘炎和 PD 进行半定量(0-3)分级。对 USR 的四种定义进行了研究:USR1:无滑膜肥厚(SH)和腱鞘炎;USR2:无滑膜肥厚(SH)和腱鞘炎:SH≤1,PD=0;USR3:结果:结果:共招募了80名患者,其中12人未服药。SDAI、CDIA、DAS28、DAS44和ACR/EULAR布尔标准的总体缓解率分别为100.0%、83.7%、91.2%、96.2%和80.0%。根据所有指标,100% 的无药患者病情缓解。USR1、USR2、USR3和USR4的无药缓解率与治疗缓解率分别为58.3%、66.7%、66.7%、83.3%与70.6%、85.3%、88.2%、91.2%:虽然临床缓解似乎在无药患者中更常见,但USR在治疗中更常被观察到。
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来源期刊
CiteScore
6.10
自引率
18.90%
发文量
377
审稿时长
3-6 weeks
期刊介绍: Clinical and Experimental Rheumatology is a bi-monthly international peer-reviewed journal which has been covering all clinical, experimental and translational aspects of musculoskeletal, arthritic and connective tissue diseases since 1983.
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