治疗至靶策略24个月后双能CT和超声对痛风消退的时间过程：来自痛风- dectus研究的结果。

IF 3.8 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine Pub Date : 2025-03-24 DOI:10.1016/j.jbspin.2025.105892

Tristan Pascart , Pascal Richette , Valérie Bousson , Sébastien Ottaviani , Hang-Korng Ea , Frédéric Lioté , Augustin Latourte , Thomas Bardin , Jérémy Ora , Aurore Pacaud , Marie Vandecandelaere , Hélène Luraschi , Charlotte Jauffret , Victor Laurent , Mathilde Boissel , Laurène Norberciak , Julie Legrand , Guillaume Lefevre , Vincent Ducoulombier , Jean-François Budzik

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引用次数: 0

摘要

目的：该研究的主要目的是评估痛风患者在接受T2T降尿酸治疗的前24个月，用双能CT （DECT）和超声（US）测量痛风石体积的动力学。方法：这是一项前瞻性、多中心、24个月的纵向先导研究，包括ULT-naïve痛风和US痛风患者。在基线、6个月、12个月和24个月进行临床就诊、膝关节和足部DECT和US扫描。选取美国鉴定的最大地形石作为索引地形石。主要结局是在所有时间点用US和DECT测量的风疹指数体积的绝对体积变化和相对于基线的变化，并通过Spearman相关系数（ρ）评估它们的相关性。结果：55例患者(63.1（12.3）岁，主要为男性（47/55(85.5%)），基线血清尿酸水平为8.73 mg/dL [7.93；9.52]被纳入。用US测量的指数地形体积从中位数[四分位数间距]0.61 cm3 [0.30；1.20]基线至0.07 cm3 [0；0.50]在第24个月，DECT从0.1 cm3 [0；0.63]基线至0 cm3 [0；在第24个月。US和DECT测量的指数地形体积的相对变化分别为-56% [-90；0]和-96% [-100；-34]在M6， -84% [-100；-13]和-100% [-100；-89]在M12， -96% [-100；-72]和-100% [-100；-100]在M24。在第6个月，相对地形体积变化的相关性较弱(ρ=0.39 [0.01；0.74])，第12个月时为中度(ρ=0.43 [-0.14；0.82])和24 (ρ=0.42 [-0.01；0.73])。结论：T2T患者在DECT患者24个月时可获得完全的结节消退，但在US患者中没有，这在随访期间提供了更大的体积评估可变性。

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Time-course of tophus resolution on Dual-energy CT and ultrasound after 24 months of a treat-to-target strategy: Results from GOUT-DECTUS study

Objectives

The main objective of the study was to evaluate the kinetics of tophus volume measured with dual-energy CT (DECT) and ultrasound (US) in patients with gout during their first 24 months of treat-to-target (T2T) urate-lowering therapy.

Methods

This was a prospective, multicenter, 24-month longitudinal pilot study including ULT-naïve patients with gout and US tophi. Clinical visits, and DECT and US scans of the knees and feet were performed at baseline, 6, 12 and 24 months. The largest tophus identified by US was chosen as the index tophus. The primary outcome was the change in the absolute volume and relative change from baseline of the tophus index volume measured with US and with DECT at all timepoints, with their correlation assessed by the Spearman correlation coefficient (ρ).

Results

A total of 55 patients (63.1 (12.3) years old, predominantly male (47/55 [85.5%]), with baseline serum urate levels of 8.73 mg/dL [7.93; 9.52] were included. Index tophus volume measured with US changed from median [inter-quartile range] 0.61 cm³ [0.30; 1.20] at baseline to 0.07 cm³ [0; 0.50] at month 24, and with DECT from 0.1 cm³ [0; 0.63] at baseline to 0 cm³ [0; 0] at month 24. Relative changes in index tophus volume measured with US and DECT were respectively −56% [−90; 0] and −96% [−100; −34] at M6, −84% [−100; −13] and −100% [−100; −89] at M12, and −96% [−100; −72] and −100% [−100; −100] at M24. The correlation for relative tophus volume change was weak at month 6 (ρ = 0.39 [0.01; 0.74]) and moderate at months 12 (ρ = 0.43 [−0.14; 0.82]) and 24 (ρ = 0.42 [−0.01; 0.73]).

Conclusion

Complete tophus resolution is obtained at 24 months of T2T in DECT but not in US, which provided a greater variability of volumetric assessments throughout follow-up.

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来源期刊

Joint Bone Spine 医学-风湿病学

CiteScore

4.50

自引率

11.90%

发文量

184

审稿时长

25 days

期刊介绍： Bimonthly e-only international journal, Joint Bone Spine publishes in English original research articles and all the latest advances that deal with disorders affecting the joints, bones, and spine and, more generally, the entire field of rheumatology. All submitted manuscripts to the journal are subjected to rigorous peer review by international experts: under no circumstances does the journal guarantee publication before the editorial board makes its final decision. (Surgical techniques and work focusing specifically on orthopedic surgery are not within the scope of the journal.)Joint Bone Spine is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey platforms.