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

被引：64

作者：

Filippou, Georgios ^{[1
]}

Sakellariou, Garifallia ^{[2
]}

Scire, Carlo Alberto ^{[1
,3
]}

Carrara, Greta ^{[3
]}

Rumi, Federica ^{[3
]}

Bellis, Emanuela ^{[4
]}

Adinolfi, Antonella ^{[5
]}

Batticciotto, Alberto ^{[6
]}

Bortoluzzi, Alessandra ^{[1
]}

Cagnotto, Giovanni ^{[7
]}

Caprioli, Marta ^{[8
]}

Canzoni, Marco ^{[9
]}

Cavatorta, Francesco Paolo ^{[10
]}

De Lucia, Orazio ^{[11
]}

Di Sabatino, Valentina ^{[5
]}

Draghessi, Antonella ^{[12
]}

Farina, Ilaria ^{[1
]}

Focherini, Maria Cristina ^{[13
]}

Gabba, Alessandra ^{[14
]}

Gutierrez, Marwin ^{[15
]}

Idolazzi, Luca ^{[16
]}

Luccioli, Filippo ^{[17
]}

Macchioni, Pierluigi ^{[18
]}

Massarotti, Marco Sergio ^{[19
]}

Mastaglio, Claudio ^{[20
]}

Menza, Luana ^{[20
]}

Muratore, Maurizio ^{[21
]}

Parisi, Simone ^{[22
]}

Picerno, Valentina ^{[23
]}

Piga, Matteo ^{[14
]}

Ramonda, Roberta ^{[24
]}

Raffeiner, Bernd ^{[25
]}

Rossi, Daniela ^{[26
]}

Rossi, Silvia ^{[2
]}

Rossini, Paola ^{[27
]}

Scioscia, Crescenzio ^{[28
]}

Venditti, Carlo ^{[29
]}

Volpe, Alessandro ^{[10
]}

Iagnocco, Annamaria ^{[30
]}

机构：

[1] Univ Ferrara, Dept Med Sci, Sect Rheumatol, Ferrara, Italy

[2] Univ Pavia, IRCCS Policlin San Matteo Fdn, Chair & Div Rheumatol, Pavia, Italy

[3] Italian Soc Rheumatol SIR, Epidemiol Unit, Milan, Italy

[4] Mauriziano Hosp, Rheumatol Unit, Turin, Italy

[5] Univ Siena, Rheumatol Sect, Dept Med Surg & Neurosci, Siena, Italy

[6] Luigi Sacco Univ Hosp, Rheumatol Dept, Milan, Italy

[7] Lund Univ, Skane Univ Hosp, Dept Clin Sci, Rheumatol, Lund, Sweden

[8] Humanitas Res Hosp, Div Rheumatol & Clin Immunol, Rozzano, Italy

[9] Azienda Osped St Andrea, Rheumatol Unit, Rome, Italy

[10] AOUP Santa Chiara, Rheumatol Unit, Trento, Italy

[11] ASST Ctr Traumatol Ortoped G Pini CTO, Dept Rheumatol, Milan, Italy

[12] Univ Policlin Marche, Clin Reumatol, Dept Rheumatol, Jesi, Italy

[13] Infermi Hosp, Rheumatol Unit, Rimini, Italy

[14] AOU Univ Clin Cagliari, Rheumatol Unit, Monserrato, Italy

[15] Inst Nacl Rehabil, Mexico City, DF, Mexico

[16] Osped Civile, Rheumatol Unit, Verona, Italy

[17] Osped S Maria Misericordia, Rheumatol Unit, Perugia, Italy

[18] Arcispedale Santa Maria Nuova IRCCS, Rheumatol Unit, Reggio Emilia, Italy

[19] Univ Hosp Morecambe Bay NHS Fdn Trust, Royal Lancaster Infirm, Dept Rheumatol, Lancaster, England

[20] Moriggia Pelascini Hosp, Rheumatol Unit, Gravedona, Italy

[21] A Galateo Hosp, Rheumatol Unit, San Cesario Di Lecce, Italy

[22] AOU Citta Salute & Sci Torino, SC Reumatol, Turin, Italy

[23] Azienda Osped Reg San Carlo, Rheumatol Unit, Potenza, Basilicata, Italy

[24] Univ Padua, DIMED, Dept Med, Rheumatol Unit, Padua, Italy

[25] Bolzano Hosp, Rheumatol Unit, Bolzano, Italy

[26] G Bosco Hosp, SS Immunoreumatol, Turin, Italy

[27] PO Destra Secchia, Rheumatol Unit, Pieve Di Coriano, Italy

[28] Policlin Univ Bari, DIM Sez Reumatol, Bari, Italy

[29] AO Rummo di Benevento, Rheumatol Unit, Benevento, Italy

[30] Univ Turin, Dipartimento Sci Clin & Biol, Turin, Italy

来源：

ANNALS OF THE RHEUMATIC DISEASES | 2018年 / 77卷 / 09期

关键词：

HEALTH-ASSESSMENT QUESTIONNAIRE; CLINICAL REMISSION; AMERICAN-COLLEGE; MUSCULOSKELETAL ULTRASOUND; EULAR RECOMMENDATIONS; TRIALS; PROGRESSION; MANAGEMENT; CRITERIA; CLASSIFICATION;

D O I：

10.1136/annrheumdis-2018-213217

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：1283 / 1289

页数：7

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