RESEARCH - Clinical and US remission determines chances of relapse in early and long-standing RA

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Ann Rheum Dis. 2010 Nov 19.

Clinical and ultrasonographic remission determines different chances

of relapse in early and long standing rheumatoid arthritis.

Peluso G, Michelutti A, Bosello S, Gremese E, Tolusso B, Ferraccioli G.

Abstract

OBJECTIVES: Treatment of rheumatoid arthritis (RA) should aim at full

remission. The aims of this study were to define: (1) how many

patients reached ultrasound power Doppler (US-PD) remission in a

cohort of patients with early RA (ERA) compared with longstanding RA

(LSRA); (2) possible predictors of US-PD remission; and (3) how many

patients with and without US-PD remission relapsed after 1 year of

follow-up in ERA and LSRA.

METHODS: 48 patients with ERA and 46 with LSRA with disease activity

score <1.6 underwent US assessment. Six hand and wrist joints were

studied for active synovitis. 56.2% of patients with ERA and 50.0% of

those with LSRA fulfilled American College of Rheumatology (ACR)

remission criteria.

RESULTS: 43.7% of patients with ERA and 17.4% of those with LSRA had

no evidence of synovitis at US evaluation. Using a stricter clinical

definition of remission (ie, ACR criteria), US evaluation confirmed

clinical remission in 66.7% of patients with ERA and 26.1% of those

with LSRA. Early disease was predictive of clinical US remission.

20.0% of patients with RA who had a negative PD signal at the US

evaluation had a flare during the 12-month follow-up period compared

with 47.1% of patients who had a positive PD signal.

CONCLUSION: US-PD remission occurs in half of patients with ERA and in

a minority of patients with LSRA in clinical remission. Early disease

seems to be the major determinant of full remission.

PMID: 21097799

http://www.ncbi.nlm.nih.gov/pubmed/21097799

Not an MD