van der Meulen Coen, Kortekaas Marion C, D'Agostino Maria Antonietta, Kroon Féline P B, Rosendaal Frits R, Kloppenburg Margreet
Rheumatology, Leiden University Medical Center, Leiden, Netherlands
Department of Rheumatology, Leids Universitair Medisch Centrum, Leiden, Netherlands.
RMD Open. 2024 Dec 31;10(4):e005002. doi: 10.1136/rmdopen-2024-005002.
Inflammation is increasingly recognised as a treatment target in hand osteoarthritis, and therefore correct measurement of local inflammation is essential. This study aimed to assess ultrasound scoring of synovitis and the additional value of the Global OMERACT/EULAR Ultrasound Synovitis Score (GLOESS) in hand osteoarthritis.
Data from the randomised, double-blinded Hand Osteoarthritis Prednisolone Efficacy (HOPE) trial were used. The HOPE trial included patients with painful, inflammatory hand OA, treated with prednisolone or placebo (1:1). Ultrasound was performed in 30 hand joints at weeks 0, 6 and 14. Effusion, synovial thickening and Doppler signal were measured, the GLOESS was calculated from the latter two. Joint tenderness on palpation was assessed semiquantitatively (0-3), soft swelling as present/absent. Changes in ultrasound scores, and their association with change in joint tenderness or soft swelling, were investigated using generalised estimating equations. Effect sizes were calculated.
Of 92 included patients 79% were women, with mean (SD) age 63.9 (8.8) and body mass index 27.2 (4.6). Synovial thickening was the most prevalent. All ultrasound scores were strongly associated with joint tenderness and soft swelling cross-sectionally. There was no association of change in ultrasound scores with change in tenderness, but there was with change in soft tissue swelling. Synovial thickening and the GLOESS responded to treatment (effect size -0.39 (-0.72 to -0.07), -0.39 (-0.71 to -0.07), respectively).
Various ultrasound scores were associated with joint tenderness and soft swelling. The GLOESS and synovial thickening were both responsive to treatment, but GLOESS was not superior to synovial thickening alone.
炎症越来越被认为是手部骨关节炎的一个治疗靶点，因此准确测量局部炎症至关重要。本研究旨在评估手部骨关节炎中滑膜炎的超声评分以及全球OMERACT/EULAR超声滑膜炎评分（GLOESS）的附加价值。
使用来自随机、双盲的手部骨关节炎泼尼松龙疗效（HOPE）试验的数据。HOPE试验纳入了患有疼痛性炎症性手部骨关节炎的患者，给予泼尼松龙或安慰剂治疗（1:1）。在第0、6和14周对30个手部关节进行超声检查。测量积液、滑膜增厚和多普勒信号，根据后两者计算GLOESS。触诊时的关节压痛进行半定量评估（0-3），软组织肿胀评估为存在/不存在。使用广义估计方程研究超声评分的变化及其与关节压痛或软组织肿胀变化的关联。计算效应量。
92例纳入患者中，79%为女性，平均（标准差）年龄63.9（8.8）岁，体重指数27.2（4.6）。滑膜增厚最为常见。所有超声评分与关节压痛和软组织肿胀在横断面均密切相关。超声评分的变化与压痛变化无关联，但与软组织肿胀变化有关联。滑膜增厚和GLOESS对治疗有反应（效应量分别为-0.39（-0.72至-0.07），-0.39（-0.71至-0.07））。
各种超声评分与关节压痛和软组织肿胀相关。GLOESS和滑膜增厚均对治疗有反应，但GLOESS并不优于单独的滑膜增厚。
