Rheumatoid Arthritis Patient With Remission :Ultrasonographic Disease Activity
Conditions
Keywords
Rheumatoid arthritis, remission, ultrasound
Brief summary
Evaluate correlations between the validated 12 joints-Naredo ultrasound score (B-mode (0-3), PD (0-3) or PDUS (0-3, max between B-mode or PD)) and the DAS28-ESR, DAS28-CRP, CDAI, SDAI and ACR-EULAR criteria for remission in routine care.
Detailed description
Clinical remission is now a realistic goal in managing rheumatoid arthritis (RA) with treat to target strategy assessed according to different composite scores (DAS28, Simplified Disease Activity Index (SDAI), Clinical Disease Activity Index (CDAI), ACR-EULAR 2011 for remission). There are, however, no validated ultrasound remission criteria because of continuing uncertainty on the signification of persistent synovial hypertrophy in B-mode or Power Doppler (PD) mode in RA patients in clinical remission. The objective was to evaluate correlations between the validated 12 joints-Naredo ultrasound score (B-mode (0-3), PD (0-3) or PDUS (0-3, max between B-mode or PD)) and the DAS28-ESR, DAS28-CRP, CDAI, SDAI and ACR-EULAR criteria for remission in routine care. This french multicenter cross-sectional study took place in 11 rheumatology departments. The inter and intra-observer reproducibility for the ultrasound scoring was good to excellent. Inclusion criteria were as follows: RA meeting ACR-EULAR criteria, \<15 years of progression, DAS-28-ESR\<2.6 for at least 3 months, with a stable treatment including corticoids if necessary (equivalent prednisone\<0.1 mg/kg) for 6 months. A standardized US examination was performed by an experience ultrasonographist blinded to clinical data. Spearman's correlation coefficients were determined between the Naredo12 B-mode (min-max,0-36), PD mode (0-36) and PDUS (0-36) scores and the different clinical remission scores. The impact of disease duration or duration of the clinical remission on ultrasound scores was also assessed (Kruskall-Wallis's test).
Interventions
None listed
Sponsors
University Hospital, Grenoble
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults (âged of 18 or more), * Rheumatoid arthritis according to ACR-EULAR 2010 criteria, during less than 10 years at least * Remission according to DAS28-VS (\<2.6) since 3 months at least, * Disease modifying anti-rheumatic drugs and/or biotherapy stable dose since 6 months at least * Steroids ≤0.1 mg/kg/day without high dose during the last 3 months * Oral and written information and consent
Exclusion criteria
* Patient participating to a clinical trial about rheumatoid arthritis treatment * Patient under administrative supervision
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| correlation between ultrasonography score Naredo12 B-mode and disease activity score (DAS28, SDAI, CDAI) | august 2015-april 2016 | Composit outcome measure : Ultrasonography score PD mode (0-36) Disease activityscore DAS28-ESR (0-10) Disease activity score DAS28-CRP (0-10) Disease activity score SDAI (0-86) Disease activity score CDAI (0-76) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Correlation between ultrasonographic score PD mode and disease activity scores (DAS28, SDAI, CDAI). | august 2015-april 2016 | Composit outcome measure : Ultrasonography score PD mode (0-36) Disease activityscore DAS28-ESR (0-10) Disease activity score DAS28-CRP (0-10) Disease activity score SDAI (0-86) Disease activity score CDAI (0-76) |
| Correlation between ultrasonography scores PDUS and disease activity scores (DAS28, SDAI, CDAI). | august 2015-april 2016 | Composit outcome measure : Ultrasonography score PD mode (0-36) Disease activityscore DAS28-ESR (0-10) Disease activity score DAS28-CRP (0-10) Disease activity score SDAI (0-86) Disease activity score CDAI (0-76) |
Outcome results
None listed