Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan.
Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan.
Scand J Rheumatol. 2021 Nov;50(6):436-441. doi: 10.1080/03009742.2021.1876914. Epub 2021 Mar 15.
: Using multicentre ultrasound (US) cohort data among patients with rheumatoid arthritis (RA), we aimed to identify baseline factors that permit differentiation between two patient cohorts achieving US remission and clinical remission, and to determine the factors contributing to the discrepancy.: We reviewed 248 Japanese patients diagnosed with RA who underwent treatment with biological disease-modifying anti-rheumatic drugs at 13 centres. We performed US assessments of the synovia of 22 joints. We assessed the percentages of patients with clinical remission and US remission, defined as total power Doppler scores of 0 at 12 months.: The 87 patients who achieved US remission were divided into a group that achieved both clinical and US remission (n = 53) and a group that achieved US remission only (n = 34). Baseline factors that were significantly and independently associated with clinical remission at 12 months among patients who also achieved US remission included short disease duration, the presence of concomitant methotrexate use, and low patient global assessment score (p < 0.05, p < 0.05, and p < 0.005, respectively).: RA patients with baseline high patient global assessment scores and long disease duration at baseline were unlikely to achieve clinical remission even after achieving US remission. Objective joint assessments using US provide additional information of potential importance for the management of RA.
:利用类风湿关节炎(RA)患者的多中心超声(US)队列数据,我们旨在确定能够区分达到 US 缓解和临床缓解的两个患者队列的基线因素,并确定导致差异的因素。:我们回顾了在 13 个中心接受生物疾病修饰抗风湿药物治疗的 248 名日本 RA 患者。我们对 22 个关节的滑膜进行了 US 评估。我们评估了达到临床缓解和 US 缓解的患者比例,定义为 12 个月时总功率多普勒评分均为 0。:达到 US 缓解的 87 名患者分为同时达到临床和 US 缓解的组(n=53)和仅达到 US 缓解的组(n=34)。在同时达到 US 缓解的患者中,与 12 个月时达到临床缓解相关的显著且独立的基线因素包括疾病持续时间短、同时使用甲氨蝶呤和患者总体评估评分低(p<0.05、p<0.05 和 p<0.005)。:即使达到 US 缓解,基线时患者总体评估评分高和疾病持续时间长的 RA 患者也不太可能达到临床缓解。使用 US 进行客观关节评估为 RA 的治疗提供了潜在重要的额外信息。