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 Clinical and experimental rheumatology Pub Date : 2024-11-01 Epub Date: 2024-10-15 DOI:10.55563/clinexprheumatol/mf8sub

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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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.

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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。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and experimental rheumatology 医学-风湿病学

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.