b超检测手部腱鞘炎能否预测类风湿关节炎临床缓解期的丧失?结果来自现实生活中的队列

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
R. Micheroli, A. Scherer, K. Bürki, P. Zufferey, M. Nissen, L. Brulhart, B. Möller, H. Ziswiler, A. Ciurea, G. Tamborrini
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Cox proportional hazard models were used for time-to-event analysis until the loss of remission, after adjustment for multiple confounders. The impact of baseline US performed early in remission and the advent of flares at different fixed time periods after baseline were investigated in sensitivity analysis. Results Tenosynovitis was detected in 10% of 402 rheumatoid arthritis patients in remission. At baseline, USTS+ patients in remission had significantly higher DAS28-ESR (mean (SD): USTS– 1.8 (0.5) versus USTS+ 2.0 (0.5); p = 0.0019) and higher additional disease activity parameters, such as physician global assessment, and simplified- and clinical-disease activity index. Joint synovitis detected by B-mode US was associated with tenosynovitis (mean (SD) 7.2 (6.3) in USTS– versus 9.0 (5.4) in USTS+, respectively; p = 0.02). A disease flare was observed in 69% of remission phases, with no differences in the time to loss of remission between USTS+ and USTS– groups. 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引用次数: 0

摘要

摘要目的us检测腱鞘炎(USTS)在类风湿关节炎治疗中的作用仍有争议。本研究的目的是调查腱鞘炎是否可以预测现实生活中缓解期类风湿关节炎患者的发作。方法来自瑞士临床质量管理队列的类风湿关节炎患者纳入本研究,如果他们处于临床缓解,28关节疾病活动评分(DAS28-ESR) <2.6,并且具有可用的b型腱鞘炎评分。根据有无腱鞘炎(USTS+ vs. USTS -)对患者进行分层。在调整多个混杂因素后,使用Cox比例风险模型进行时间-事件分析,直至缓解丧失。在敏感性分析中,研究了基线US在缓解期早期的影响,以及基线后不同固定时间段内耀斑的出现。结果402例缓解期类风湿关节炎患者中有10%检出腱鞘炎。基线时,处于缓解期的USTS+患者的DAS28-ESR显著更高(平均(SD): USTS - 1.8 (0.5) vs USTS+ 2.0 (0.5);P = 0.0019)和更高的其他疾病活动性参数,如医生总体评估,简化和临床疾病活动性指数。b型超声检测到的关节滑膜炎与腱鞘炎相关(ussts -组平均(SD)为7.2 (6.3),ussts +组平均(SD)为9.0 (5.4);P = 0.02)。在69%的缓解期观察到疾病爆发,在USTS+组和USTS -组之间的缓解消失时间没有差异。结论:虽然us检测到的腱鞘炎与临床缓解的类风湿关节炎患者较高的疾病活动性参数相关,但它不能预测急性发作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Does tenosynovitis of the hand detected by B-mode ultrasound predict loss of clinical remission in rheumatoid arthritis? Results from a real-life cohort
Abstract Objective The role of US-detected tenosynovitis (USTS) in the management of rheumatoid arthritis remains controversial. The aim of this study was to investigate whether tenosynovitis can predict a flare in rheumatoid arthritis patients in remission in a real-life cohort. Methods Rheumatoid arthritis patients from the Swiss Clinical Quality Management cohort were included in this study if they were in clinical remission, defined by 28-joint disease activity score (DAS28-ESR) <2.6, and had an available B-mode tenosynovitis score. The patients were stratified according to the presence or absence of tenosynovitis (USTS+ vs. USTS–). Cox proportional hazard models were used for time-to-event analysis until the loss of remission, after adjustment for multiple confounders. The impact of baseline US performed early in remission and the advent of flares at different fixed time periods after baseline were investigated in sensitivity analysis. Results Tenosynovitis was detected in 10% of 402 rheumatoid arthritis patients in remission. At baseline, USTS+ patients in remission had significantly higher DAS28-ESR (mean (SD): USTS– 1.8 (0.5) versus USTS+ 2.0 (0.5); p = 0.0019) and higher additional disease activity parameters, such as physician global assessment, and simplified- and clinical-disease activity index. Joint synovitis detected by B-mode US was associated with tenosynovitis (mean (SD) 7.2 (6.3) in USTS– versus 9.0 (5.4) in USTS+, respectively; p = 0.02). A disease flare was observed in 69% of remission phases, with no differences in the time to loss of remission between USTS+ and USTS– groups. Conclusion While US-detected tenosynovitis was associated with higher disease activity parameters in rheumatoid arthritis patients in clinical remission, it was not able to predict a flare.
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来源期刊
Journal of Ultrasonography
Journal of Ultrasonography RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
2.30
自引率
0.00%
发文量
58
审稿时长
20 weeks
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