The predictive role of ultrasound-detected tenosynovitis and joint synovitis for flare in patients with rheumatoid arthritis in stable remission. Results of an Italian multicentre study of the Italian Society for Rheumatology Group for Ultrasound: the STARTER study

Georgios Filippou, Garifallia Sakellariou, Carlo Alberto Scirè, Greta Carrara, Federica Rumi, Emanuela Bellis, Antonella Adinolfi, Alberto Batticciotto, Alessandra Bortoluzzi, Giovanni Cagnotto, Marta Caprioli, Marco Canzoni, Francesco Paolo Cavatorta, Orazio De Lucia, Valentina Di Sabatino, Antonella Draghessi, Ilaria Farina, Maria Cristina Focherini, Alessandra Gabba, Marwin GutierrezLuca Idolazzi, Filippo Luccioli, Pierluigi Macchioni, Marco Sergio Massarotti, Claudio Mastaglio, Luana Menza, Maurizio Muratore, Simone Parisi, Valentina Picerno, Matteo Piga, Roberta Ramonda, Bernd Raffeiner, Daniela Rossi, Silvia Rossi, Paola Rossini, Crescenzio Scioscia, Carlo Venditti, Alessandro Volpe, Annamaria Iagnocco

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To define the role of ultrasound (US) for the assessment of patients with rheumatoid arthritis (RA) in clinical remission, including joint and tendon evaluation.

METHODS: A multicentre longitudinal study has been promoted by the US Study Group of the Italian Society for Rheumatology. 25 Italian centres participated, enrolling consecutive patients with RA in clinical remission. All patients underwent complete clinical assessment (demographic data, disease characteristics, laboratory exams, clinical assessment of 28 joints and patient/physician-reported outcomes) and Power Doppler (PD) US evaluation of wrist, metacarpalphalangeal joints, proximal interphalangeal joints and synovial tendons of the hands and wrists at enrolment, 6 and 12 months. The association between clinical and US variables with flare, disability and radiographic progression was evaluated by univariable and adjusted logistic regression models.

RESULTS: 361 patients were enrolled, the mean age was 56.20 (±13.31) years and 261 were women, with a mean disease duration of 9.75 (±8.07) years. In the 12 months follow-up, 98/326 (30.1%) patients presented a disease flare. The concurrent presence of PD positive tenosynovitis and joint synovitis predicted disease flare, with an OR (95% CI) of 2.75 (1.45 to 5.20) in crude analyses and 2.09 (1.06 to 4.13) in adjusted analyses. US variables did not predict the worsening of function or radiographic progression. US was able to predict flare at 12 months but not at 6 months.

CONCLUSIONS: PD positivity in tendons and joints is an independent risk factor of flare in patients with RA in clinical remission. Musculoskeletal ultrasound evaluation is a valuable tool to monitor and help decision making in patients with RA in clinical remission.

Original languageEnglish
Pages (from-to)1283-1289
Number of pages7
JournalAnnals of the Rheumatic Diseases
Volume77
Issue number9
DOIs
Publication statusPublished - Sep 2018

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Tenosynovitis
Synovitis
Rheumatology
Multicenter Studies
Rheumatoid Arthritis
Joints
Ultrasonics
Tendons
Logistic Models
Clinical laboratories
Wrist Joint
Doppler Ultrasonography
Wrist
Longitudinal Studies
Logistics
Decision Making
Hand
Decision making
Demography
Physicians

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The predictive role of ultrasound-detected tenosynovitis and joint synovitis for flare in patients with rheumatoid arthritis in stable remission. Results of an Italian multicentre study of the Italian Society for Rheumatology Group for Ultrasound : the STARTER study. / Filippou, Georgios; Sakellariou, Garifallia; Scirè, Carlo Alberto; Carrara, Greta; Rumi, Federica; Bellis, Emanuela; Adinolfi, Antonella; Batticciotto, Alberto; Bortoluzzi, Alessandra; Cagnotto, Giovanni; Caprioli, Marta; Canzoni, Marco; Cavatorta, Francesco Paolo; De Lucia, Orazio; Di Sabatino, Valentina; Draghessi, Antonella; Farina, Ilaria; Focherini, Maria Cristina; Gabba, Alessandra; Gutierrez, Marwin; Idolazzi, Luca; Luccioli, Filippo; Macchioni, Pierluigi; Massarotti, Marco Sergio; Mastaglio, Claudio; Menza, Luana; Muratore, Maurizio; Parisi, Simone; Picerno, Valentina; Piga, Matteo; Ramonda, Roberta; Raffeiner, Bernd; Rossi, Daniela; Rossi, Silvia; Rossini, Paola; Scioscia, Crescenzio; Venditti, Carlo; Volpe, Alessandro; Iagnocco, Annamaria.

In: Annals of the Rheumatic Diseases, Vol. 77, No. 9, 09.2018, p. 1283-1289.

Research output: Contribution to journalArticle

Filippou, G, Sakellariou, G, Scirè, CA, Carrara, G, Rumi, F, Bellis, E, Adinolfi, A, Batticciotto, A, Bortoluzzi, A, Cagnotto, G, Caprioli, M, Canzoni, M, Cavatorta, FP, De Lucia, O, Di Sabatino, V, Draghessi, A, Farina, I, Focherini, MC, Gabba, A, Gutierrez, M, Idolazzi, L, Luccioli, F, Macchioni, P, Massarotti, MS, Mastaglio, C, Menza, L, Muratore, M, Parisi, S, Picerno, V, Piga, M, Ramonda, R, Raffeiner, B, Rossi, D, Rossi, S, Rossini, P, Scioscia, C, Venditti, C, Volpe, A & Iagnocco, A 2018, 'The predictive role of ultrasound-detected tenosynovitis and joint synovitis for flare in patients with rheumatoid arthritis in stable remission. Results of an Italian multicentre study of the Italian Society for Rheumatology Group for Ultrasound: the STARTER study', Annals of the Rheumatic Diseases, vol. 77, no. 9, pp. 1283-1289. https://doi.org/10.1136/annrheumdis-2018-213217
Filippou, Georgios ; Sakellariou, Garifallia ; Scirè, Carlo Alberto ; Carrara, Greta ; Rumi, Federica ; Bellis, Emanuela ; Adinolfi, Antonella ; Batticciotto, Alberto ; Bortoluzzi, Alessandra ; Cagnotto, Giovanni ; Caprioli, Marta ; Canzoni, Marco ; Cavatorta, Francesco Paolo ; De Lucia, Orazio ; Di Sabatino, Valentina ; Draghessi, Antonella ; Farina, Ilaria ; Focherini, Maria Cristina ; Gabba, Alessandra ; Gutierrez, Marwin ; Idolazzi, Luca ; Luccioli, Filippo ; Macchioni, Pierluigi ; Massarotti, Marco Sergio ; Mastaglio, Claudio ; Menza, Luana ; Muratore, Maurizio ; Parisi, Simone ; Picerno, Valentina ; Piga, Matteo ; Ramonda, Roberta ; Raffeiner, Bernd ; Rossi, Daniela ; Rossi, Silvia ; Rossini, Paola ; Scioscia, Crescenzio ; Venditti, Carlo ; Volpe, Alessandro ; Iagnocco, Annamaria. / The predictive role of ultrasound-detected tenosynovitis and joint synovitis for flare in patients with rheumatoid arthritis in stable remission. Results of an Italian multicentre study of the Italian Society for Rheumatology Group for Ultrasound : the STARTER study. In: Annals of the Rheumatic Diseases. 2018 ; Vol. 77, No. 9. pp. 1283-1289.
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title = "The predictive role of ultrasound-detected tenosynovitis and joint synovitis for flare in patients with rheumatoid arthritis in stable remission. Results of an Italian multicentre study of the Italian Society for Rheumatology Group for Ultrasound: the STARTER study",
abstract = "OBJECTIVE: To define the role of ultrasound (US) for the assessment of patients with rheumatoid arthritis (RA) in clinical remission, including joint and tendon evaluation.METHODS: A multicentre longitudinal study has been promoted by the US Study Group of the Italian Society for Rheumatology. 25 Italian centres participated, enrolling consecutive patients with RA in clinical remission. All patients underwent complete clinical assessment (demographic data, disease characteristics, laboratory exams, clinical assessment of 28 joints and patient/physician-reported outcomes) and Power Doppler (PD) US evaluation of wrist, metacarpalphalangeal joints, proximal interphalangeal joints and synovial tendons of the hands and wrists at enrolment, 6 and 12 months. The association between clinical and US variables with flare, disability and radiographic progression was evaluated by univariable and adjusted logistic regression models.RESULTS: 361 patients were enrolled, the mean age was 56.20 (±13.31) years and 261 were women, with a mean disease duration of 9.75 (±8.07) years. In the 12 months follow-up, 98/326 (30.1{\%}) patients presented a disease flare. The concurrent presence of PD positive tenosynovitis and joint synovitis predicted disease flare, with an OR (95{\%} CI) of 2.75 (1.45 to 5.20) in crude analyses and 2.09 (1.06 to 4.13) in adjusted analyses. US variables did not predict the worsening of function or radiographic progression. US was able to predict flare at 12 months but not at 6 months.CONCLUSIONS: PD positivity in tendons and joints is an independent risk factor of flare in patients with RA in clinical remission. Musculoskeletal ultrasound evaluation is a valuable tool to monitor and help decision making in patients with RA in clinical remission.",
author = "Georgios Filippou and Garifallia Sakellariou and Scir{\`e}, {Carlo Alberto} and Greta Carrara and Federica Rumi and Emanuela Bellis and Antonella Adinolfi and Alberto Batticciotto and Alessandra Bortoluzzi and Giovanni Cagnotto and Marta Caprioli and Marco Canzoni and Cavatorta, {Francesco Paolo} and {De Lucia}, Orazio and {Di Sabatino}, Valentina and Antonella Draghessi and Ilaria Farina and Focherini, {Maria Cristina} and Alessandra Gabba and Marwin Gutierrez and Luca Idolazzi and Filippo Luccioli and Pierluigi Macchioni and Massarotti, {Marco Sergio} and Claudio Mastaglio and Luana Menza and Maurizio Muratore and Simone Parisi and Valentina Picerno and Matteo Piga and Roberta Ramonda and Bernd Raffeiner and Daniela Rossi and Silvia Rossi and Paola Rossini and Crescenzio Scioscia and Carlo Venditti and Alessandro Volpe and Annamaria Iagnocco",
note = "{\circledC} Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.",
year = "2018",
month = "9",
doi = "10.1136/annrheumdis-2018-213217",
language = "English",
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pages = "1283--1289",
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TY - JOUR

T1 - The predictive role of ultrasound-detected tenosynovitis and joint synovitis for flare in patients with rheumatoid arthritis in stable remission. Results of an Italian multicentre study of the Italian Society for Rheumatology Group for Ultrasound

T2 - the STARTER study

AU - Filippou, Georgios

AU - Sakellariou, Garifallia

AU - Scirè, Carlo Alberto

AU - Carrara, Greta

AU - Rumi, Federica

AU - Bellis, Emanuela

AU - Adinolfi, Antonella

AU - Batticciotto, Alberto

AU - Bortoluzzi, Alessandra

AU - Cagnotto, Giovanni

AU - Caprioli, Marta

AU - Canzoni, Marco

AU - Cavatorta, Francesco Paolo

AU - De Lucia, Orazio

AU - Di Sabatino, Valentina

AU - Draghessi, Antonella

AU - Farina, Ilaria

AU - Focherini, Maria Cristina

AU - Gabba, Alessandra

AU - Gutierrez, Marwin

AU - Idolazzi, Luca

AU - Luccioli, Filippo

AU - Macchioni, Pierluigi

AU - Massarotti, Marco Sergio

AU - Mastaglio, Claudio

AU - Menza, Luana

AU - Muratore, Maurizio

AU - Parisi, Simone

AU - Picerno, Valentina

AU - Piga, Matteo

AU - Ramonda, Roberta

AU - Raffeiner, Bernd

AU - Rossi, Daniela

AU - Rossi, Silvia

AU - Rossini, Paola

AU - Scioscia, Crescenzio

AU - Venditti, Carlo

AU - Volpe, Alessandro

AU - Iagnocco, Annamaria

N1 - © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

PY - 2018/9

Y1 - 2018/9

N2 - OBJECTIVE: To define the role of ultrasound (US) for the assessment of patients with rheumatoid arthritis (RA) in clinical remission, including joint and tendon evaluation.METHODS: A multicentre longitudinal study has been promoted by the US Study Group of the Italian Society for Rheumatology. 25 Italian centres participated, enrolling consecutive patients with RA in clinical remission. All patients underwent complete clinical assessment (demographic data, disease characteristics, laboratory exams, clinical assessment of 28 joints and patient/physician-reported outcomes) and Power Doppler (PD) US evaluation of wrist, metacarpalphalangeal joints, proximal interphalangeal joints and synovial tendons of the hands and wrists at enrolment, 6 and 12 months. The association between clinical and US variables with flare, disability and radiographic progression was evaluated by univariable and adjusted logistic regression models.RESULTS: 361 patients were enrolled, the mean age was 56.20 (±13.31) years and 261 were women, with a mean disease duration of 9.75 (±8.07) years. In the 12 months follow-up, 98/326 (30.1%) patients presented a disease flare. The concurrent presence of PD positive tenosynovitis and joint synovitis predicted disease flare, with an OR (95% CI) of 2.75 (1.45 to 5.20) in crude analyses and 2.09 (1.06 to 4.13) in adjusted analyses. US variables did not predict the worsening of function or radiographic progression. US was able to predict flare at 12 months but not at 6 months.CONCLUSIONS: PD positivity in tendons and joints is an independent risk factor of flare in patients with RA in clinical remission. Musculoskeletal ultrasound evaluation is a valuable tool to monitor and help decision making in patients with RA in clinical remission.

AB - OBJECTIVE: To define the role of ultrasound (US) for the assessment of patients with rheumatoid arthritis (RA) in clinical remission, including joint and tendon evaluation.METHODS: A multicentre longitudinal study has been promoted by the US Study Group of the Italian Society for Rheumatology. 25 Italian centres participated, enrolling consecutive patients with RA in clinical remission. All patients underwent complete clinical assessment (demographic data, disease characteristics, laboratory exams, clinical assessment of 28 joints and patient/physician-reported outcomes) and Power Doppler (PD) US evaluation of wrist, metacarpalphalangeal joints, proximal interphalangeal joints and synovial tendons of the hands and wrists at enrolment, 6 and 12 months. The association between clinical and US variables with flare, disability and radiographic progression was evaluated by univariable and adjusted logistic regression models.RESULTS: 361 patients were enrolled, the mean age was 56.20 (±13.31) years and 261 were women, with a mean disease duration of 9.75 (±8.07) years. In the 12 months follow-up, 98/326 (30.1%) patients presented a disease flare. The concurrent presence of PD positive tenosynovitis and joint synovitis predicted disease flare, with an OR (95% CI) of 2.75 (1.45 to 5.20) in crude analyses and 2.09 (1.06 to 4.13) in adjusted analyses. US variables did not predict the worsening of function or radiographic progression. US was able to predict flare at 12 months but not at 6 months.CONCLUSIONS: PD positivity in tendons and joints is an independent risk factor of flare in patients with RA in clinical remission. Musculoskeletal ultrasound evaluation is a valuable tool to monitor and help decision making in patients with RA in clinical remission.

U2 - 10.1136/annrheumdis-2018-213217

DO - 10.1136/annrheumdis-2018-213217

M3 - Article

C2 - 29886430

VL - 77

SP - 1283

EP - 1289

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

SN - 0003-4967

IS - 9

ER -