Subclinical Synovitis Measured by Ultrasound in Rheumatoid Arthritis Patients With Clinical Remission Induced by Synthetic and Biological Modifying Disease Drugs

Marcos Cruces, Soham Al Snih al snih, Natalí Serra-Bonett, Juan C. Rivas

    Research output: Contribution to journalArticle

    Abstract

    Background: Rheumatoid arthritis (RA) patients with disease in clinical remission might show subclinical synovitis, which can be related to the progress of structural joint damage. Objective: To determine and compare the degree of synovial inflammation by ultrasound (US) in patients with RA in clinical remission, treated with DMARD or combination therapy with DMARD and anti-TNF. Methods: Hospital-based cross-sectional study of 58 patients with RA in sustained remission for at least 6 months by DAS28 <2.6, who attended the Rheumatology Service at the Hospital Universitario de Caracas. Patients underwent clinical, functional, and laboratory assessments. Ultrasound was performed in hands measuring synovial effusion, synovial hypertrophy and power Doppler signal; using a semiquantitative 4-point scale of 0 = none to 3 = severe. Chi-square and t-test were used to compare the clinical, functional, laboratory and US assessments between the DMARD (N = 37) and combination therapy with DMARD and anti-TNF (N = 21) groups. A p-value <0.05 was considered statistically significant. Results: Out of 58 patients, 25.9% had remission by US and 74.1% had synovial effusion or hypertrophy or positive power Doppler signal. Non-significant differences in US synovitis between the two groups were found. Conclusions: Persistent US activity was evident in a high percentage of rheumatoid arthritis patients in clinical remission by DAS28. No differences in subclinical synovitis measured by US were found between patients with DMARD and anti-TNF-induced clinical remission.

    Original languageEnglish (US)
    JournalReumatologia Clinica
    DOIs
    StateAccepted/In press - 2017

    Fingerprint

    Synovitis
    Antirheumatic Agents
    Rheumatoid Arthritis
    Pharmaceutical Preparations
    Rheumatology
    Chi-Square Distribution
    Hypertrophy
    Hand
    Cross-Sectional Studies
    Joints
    Inflammation
    Therapeutics

    Keywords

    • Clinical remission
    • Musculoskeletal ultrasound
    • Rheumatoid arthritis
    • Subclinical synovitis

    ASJC Scopus subject areas

    • Rheumatology

    Cite this

    @article{acf81b31e02d4647904de2c8debfc84e,
    title = "Subclinical Synovitis Measured by Ultrasound in Rheumatoid Arthritis Patients With Clinical Remission Induced by Synthetic and Biological Modifying Disease Drugs",
    abstract = "Background: Rheumatoid arthritis (RA) patients with disease in clinical remission might show subclinical synovitis, which can be related to the progress of structural joint damage. Objective: To determine and compare the degree of synovial inflammation by ultrasound (US) in patients with RA in clinical remission, treated with DMARD or combination therapy with DMARD and anti-TNF. Methods: Hospital-based cross-sectional study of 58 patients with RA in sustained remission for at least 6 months by DAS28 <2.6, who attended the Rheumatology Service at the Hospital Universitario de Caracas. Patients underwent clinical, functional, and laboratory assessments. Ultrasound was performed in hands measuring synovial effusion, synovial hypertrophy and power Doppler signal; using a semiquantitative 4-point scale of 0 = none to 3 = severe. Chi-square and t-test were used to compare the clinical, functional, laboratory and US assessments between the DMARD (N = 37) and combination therapy with DMARD and anti-TNF (N = 21) groups. A p-value <0.05 was considered statistically significant. Results: Out of 58 patients, 25.9{\%} had remission by US and 74.1{\%} had synovial effusion or hypertrophy or positive power Doppler signal. Non-significant differences in US synovitis between the two groups were found. Conclusions: Persistent US activity was evident in a high percentage of rheumatoid arthritis patients in clinical remission by DAS28. No differences in subclinical synovitis measured by US were found between patients with DMARD and anti-TNF-induced clinical remission.",
    keywords = "Clinical remission, Musculoskeletal ultrasound, Rheumatoid arthritis, Subclinical synovitis",
    author = "Marcos Cruces and {Al Snih al snih}, Soham and Natal{\'i} Serra-Bonett and Rivas, {Juan C.}",
    year = "2017",
    doi = "10.1016/j.reuma.2017.08.004",
    language = "English (US)",
    journal = "Reumatologia Clinica",
    issn = "1699-258X",
    publisher = "Ediciones Doyma, S.L.",

    }

    TY - JOUR

    T1 - Subclinical Synovitis Measured by Ultrasound in Rheumatoid Arthritis Patients With Clinical Remission Induced by Synthetic and Biological Modifying Disease Drugs

    AU - Cruces, Marcos

    AU - Al Snih al snih, Soham

    AU - Serra-Bonett, Natalí

    AU - Rivas, Juan C.

    PY - 2017

    Y1 - 2017

    N2 - Background: Rheumatoid arthritis (RA) patients with disease in clinical remission might show subclinical synovitis, which can be related to the progress of structural joint damage. Objective: To determine and compare the degree of synovial inflammation by ultrasound (US) in patients with RA in clinical remission, treated with DMARD or combination therapy with DMARD and anti-TNF. Methods: Hospital-based cross-sectional study of 58 patients with RA in sustained remission for at least 6 months by DAS28 <2.6, who attended the Rheumatology Service at the Hospital Universitario de Caracas. Patients underwent clinical, functional, and laboratory assessments. Ultrasound was performed in hands measuring synovial effusion, synovial hypertrophy and power Doppler signal; using a semiquantitative 4-point scale of 0 = none to 3 = severe. Chi-square and t-test were used to compare the clinical, functional, laboratory and US assessments between the DMARD (N = 37) and combination therapy with DMARD and anti-TNF (N = 21) groups. A p-value <0.05 was considered statistically significant. Results: Out of 58 patients, 25.9% had remission by US and 74.1% had synovial effusion or hypertrophy or positive power Doppler signal. Non-significant differences in US synovitis between the two groups were found. Conclusions: Persistent US activity was evident in a high percentage of rheumatoid arthritis patients in clinical remission by DAS28. No differences in subclinical synovitis measured by US were found between patients with DMARD and anti-TNF-induced clinical remission.

    AB - Background: Rheumatoid arthritis (RA) patients with disease in clinical remission might show subclinical synovitis, which can be related to the progress of structural joint damage. Objective: To determine and compare the degree of synovial inflammation by ultrasound (US) in patients with RA in clinical remission, treated with DMARD or combination therapy with DMARD and anti-TNF. Methods: Hospital-based cross-sectional study of 58 patients with RA in sustained remission for at least 6 months by DAS28 <2.6, who attended the Rheumatology Service at the Hospital Universitario de Caracas. Patients underwent clinical, functional, and laboratory assessments. Ultrasound was performed in hands measuring synovial effusion, synovial hypertrophy and power Doppler signal; using a semiquantitative 4-point scale of 0 = none to 3 = severe. Chi-square and t-test were used to compare the clinical, functional, laboratory and US assessments between the DMARD (N = 37) and combination therapy with DMARD and anti-TNF (N = 21) groups. A p-value <0.05 was considered statistically significant. Results: Out of 58 patients, 25.9% had remission by US and 74.1% had synovial effusion or hypertrophy or positive power Doppler signal. Non-significant differences in US synovitis between the two groups were found. Conclusions: Persistent US activity was evident in a high percentage of rheumatoid arthritis patients in clinical remission by DAS28. No differences in subclinical synovitis measured by US were found between patients with DMARD and anti-TNF-induced clinical remission.

    KW - Clinical remission

    KW - Musculoskeletal ultrasound

    KW - Rheumatoid arthritis

    KW - Subclinical synovitis

    UR - http://www.scopus.com/inward/record.url?scp=85030654371&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=85030654371&partnerID=8YFLogxK

    U2 - 10.1016/j.reuma.2017.08.004

    DO - 10.1016/j.reuma.2017.08.004

    M3 - Article

    C2 - 29032909

    AN - SCOPUS:85030654371

    JO - Reumatologia Clinica

    JF - Reumatologia Clinica

    SN - 1699-258X

    ER -