TY - JOUR
T1 - Ultrasound-detected tenosynovitis independently associates with patient-reported flare in patients with rheumatoid arthritis in clinical remission
T2 - Results from the observational study STARTER of the Italian Society for Rheumatology
AU - Bellis, Emanuela
AU - Scirè, Carlo Alberto
AU - Carrara, Greta
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 - Filippou, Georgios
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 - Sakellariou, Garifallia
AU - Scioscia, Crescenzio
AU - Venditti, Carlo
AU - Volpe, Alessandro
AU - Matucci-Cerinic, Marco
AU - Iagnocco, Annamaria
PY - 2016/10/1
Y1 - 2016/10/1
N2 - 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.
AB - 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.
KW - Flare
KW - Remission
KW - rheumatoid arthritis
KW - Tenosynovitis
KW - Ultrasound
UR - http://www.scopus.com/inward/record.url?scp=84991074125&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84991074125&partnerID=8YFLogxK
U2 - 10.1093/rheumatology/kew258
DO - 10.1093/rheumatology/kew258
M3 - Article
AN - SCOPUS:84991074125
VL - 55
SP - 1826
EP - 1836
JO - Rheumatology
JF - Rheumatology
SN - 1462-0324
IS - 10
M1 - kew258
ER -