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Ultrasound-detected tenosynovitis independently associates with patient-reported flare in patients with rheumatoid arthritis in clinical remission : Results from the observational study STARTER of the Italian Society for Rheumatology

Bellis, Emanuela; Scirè, Carlo Alberto; Carrara, Greta; Adinolfi, Antonella; Batticciotto, Alberto; Bortoluzzi, Alessandra; Cagnotto, Giovanni LU ; Caprioli, Marta; Canzoni, Marco and Cavatorta, Francesco Paolo, et al. (2016) In Rheumatology (United Kingdom) 55(10). p.1826-1836
Abstract

Objectives. This study aimed to estimate the prevalence of US-detected tenosynovitis in RA patients in clinical remission and to explore its clinical correlates.Methods. A total of 427 RA patients in clinical remission were consecutively enrolled from 25 Italian rheumatology centres. Tenosynovitis and synovitis were scored by US grey scale (GS) and power Doppler (PD) semi-quantitative scoring systems at wrist and hand joints. Complete clinical assessment was performed by rheumatologists blinded to the US results. A flare questionnaire was used to assess unstable remission (primary outcome), HAQ for functional disability and radiographic erosions for damage (secondary outcomes). Cross-sectional relationships between the presence of each... (More)

Objectives. This study aimed to estimate the prevalence of US-detected tenosynovitis in RA patients in clinical remission and to explore its clinical correlates.Methods. A total of 427 RA patients in clinical remission were consecutively enrolled from 25 Italian rheumatology centres. Tenosynovitis and synovitis were scored by US grey scale (GS) and power Doppler (PD) semi-quantitative scoring systems at wrist and hand joints. Complete clinical assessment was performed by rheumatologists blinded to the US results. A flare questionnaire was used to assess unstable remission (primary outcome), HAQ for functional disability and radiographic erosions for damage (secondary outcomes). Cross-sectional relationships between the presence of each US finding and outcome variables are presented as odds ratios (ORs) and 95% CIs, both crude and adjusted for pre-specified confounders.Results. The prevalence of tenosynovitis in clinical remission was 52.5% (95% CI 0.48, 0.57) for GS and 22.7% (95% CI 0.19, 0.27) for PD, while the prevalence of synovitis was 71.6% (95% CI 0.67, 0.76) for GS and 42% (95% CI 0.37, 0.47) for PD. Among clinical correlates, PD tenosynovitis associated with lower remission duration and morning stiffness while PD synovitis did not. Only PD tenosynovitis showed a significant association with the flare questionnaire [OR 1.95 (95% CI 1.17, 3.26)]. No cross-sectional associations were found with the HAQ. The presence of radiographic erosions associated with GS and PD synovitis but not with tenosynovitis.Conclusions. US-detected tenosynovitis is a frequent finding in RA patients in clinical remission and associates with unstable remission.

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publication status
published
subject
keywords
Flare, Remission, rheumatoid arthritis, Tenosynovitis, Ultrasound
in
Rheumatology (United Kingdom)
volume
55
issue
10
pages
11 pages
publisher
Oxford University Press
external identifiers
  • scopus:84991074125
ISSN
1462-0324
DOI
10.1093/rheumatology/kew258
language
English
LU publication?
no
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c8fae246-32da-4522-ac6e-a8faffd26537
date added to LUP
2019-07-01 22:03:47
date last changed
2019-09-17 04:58:08
@article{c8fae246-32da-4522-ac6e-a8faffd26537,
  abstract     = {<p>Objectives. This study aimed to estimate the prevalence of US-detected tenosynovitis in RA patients in clinical remission and to explore its clinical correlates.Methods. A total of 427 RA patients in clinical remission were consecutively enrolled from 25 Italian rheumatology centres. Tenosynovitis and synovitis were scored by US grey scale (GS) and power Doppler (PD) semi-quantitative scoring systems at wrist and hand joints. Complete clinical assessment was performed by rheumatologists blinded to the US results. A flare questionnaire was used to assess unstable remission (primary outcome), HAQ for functional disability and radiographic erosions for damage (secondary outcomes). Cross-sectional relationships between the presence of each US finding and outcome variables are presented as odds ratios (ORs) and 95% CIs, both crude and adjusted for pre-specified confounders.Results. The prevalence of tenosynovitis in clinical remission was 52.5% (95% CI 0.48, 0.57) for GS and 22.7% (95% CI 0.19, 0.27) for PD, while the prevalence of synovitis was 71.6% (95% CI 0.67, 0.76) for GS and 42% (95% CI 0.37, 0.47) for PD. Among clinical correlates, PD tenosynovitis associated with lower remission duration and morning stiffness while PD synovitis did not. Only PD tenosynovitis showed a significant association with the flare questionnaire [OR 1.95 (95% CI 1.17, 3.26)]. No cross-sectional associations were found with the HAQ. The presence of radiographic erosions associated with GS and PD synovitis but not with tenosynovitis.Conclusions. US-detected tenosynovitis is a frequent finding in RA patients in clinical remission and associates with unstable remission.</p>},
  articleno    = {kew258},
  author       = {Bellis, Emanuela and Scirè, Carlo Alberto and Carrara, Greta and Adinolfi, Antonella and Batticciotto, Alberto and Bortoluzzi, Alessandra and Cagnotto, Giovanni and Caprioli, Marta and Canzoni, Marco and Cavatorta, Francesco Paolo and De Lucia, Orazio and Di Sabatino, Valentina and Draghessi, Antonella and Filippou, Georgios and Farina, Ilaria and Focherini, Maria Cristina and Gabba, Alessandra and Gutierrez, Marwin and Idolazzi, Luca and Luccioli, Filippo and Macchioni, Pierluigi and Massarotti, Marco Sergio and Mastaglio, Claudio and Menza, Luana and Muratore, Maurizio and Parisi, Simone and Picerno, Valentina and Piga, Matteo and Ramonda, Roberta and Raffeiner, Bernd and Rossi, Daniela and Rossi, Silvia and Rossini, Paola and Sakellariou, Garifallia and Scioscia, Crescenzio and Venditti, Carlo and Volpe, Alessandro and Matucci-Cerinic, Marco and Iagnocco, Annamaria},
  issn         = {1462-0324},
  keyword      = {Flare,Remission,rheumatoid arthritis,Tenosynovitis,Ultrasound},
  language     = {eng},
  month        = {10},
  number       = {10},
  pages        = {1826--1836},
  publisher    = {Oxford University Press},
  series       = {Rheumatology (United Kingdom)},
  title        = {Ultrasound-detected tenosynovitis independently associates with patient-reported flare in patients with rheumatoid arthritis in clinical remission : Results from the observational study STARTER of the Italian Society for Rheumatology},
  url          = {http://dx.doi.org/10.1093/rheumatology/kew258},
  volume       = {55},
  year         = {2016},
}