Clinical course and flare predictors in patients with rheumatoid arthritis in low disease activity and ultrasound remission monitored by ultrasound yearly and on-demand: A prospective 2-year observation study.

Autor: Abe T; Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-chou, Nishinomiya, Hyogo 663-8501, Japan. Electronic address: abetakeo@hyo-med.ac.jp., Tamura M; Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-chou, Nishinomiya, Hyogo 663-8501, Japan; Department of Rheumatology Medicine, Kobe City Medical Center West Hospital, 2-4 Ichiban-cho, Nagata-ku, Kobe-shi, Hyogo 653-0013, Japan., Tsuboi K; Department of Rheumatology Medicine, Kobe City Medical Center West Hospital, 2-4 Ichiban-cho, Nagata-ku, Kobe-shi, Hyogo 653-0013, Japan., Minagawa Y; Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-chou, Nishinomiya, Hyogo 663-8501, Japan., Noguchi K; Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-chou, Nishinomiya, Hyogo 663-8501, Japan., Ogita C; Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-chou, Nishinomiya, Hyogo 663-8501, Japan., Hashimoto T; Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-chou, Nishinomiya, Hyogo 663-8501, Japan., Azuma N; Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-chou, Nishinomiya, Hyogo 663-8501, Japan., Matsui K; Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-chou, Nishinomiya, Hyogo 663-8501, Japan.
Jazyk: angličtina
Zdroj: Reumatologia clinica [Reumatol Clin (Engl Ed)] 2024 Dec; Vol. 20 (10), pp. 517-525.
DOI: 10.1016/j.reumae.2024.08.001
Abstrakt: Introduction and Objectives: Ultrasound (US) remission in rheumatoid arthritis (RA) targets synovitis absence. Tenosynovitis triggers flares. Despite increased ultrasound use, flare patterns among patients with low disease activity (LDA) and ultrasound remission, especially in real-world settings, are poorly understood. This study examined flare rates and predictors of US remission in patients without synovitis or tenosynovitis.
Materials and Methods: In a study of 88 patients achieving US remission and LDA, the focus was on the time to the first flare over a 2-year follow-up. US remission, indicated by the absence of active synovitis and tenosynovitis based on a power Doppler (US-PD) score of 0, was assessed on various joints. Flares are defined by the need for additional medication or encountering a US-PD flare. They were monitored at the baseline, 1-year, and 2-year visits with further US evaluation at clinical flare-ups. Baseline factors linked to a shorter time to flare were analyzed.
Results: At 1 year, LDA and US remission rates were 75% and 92%, respectively, and at 2 years, 73% and 87% respectively. Over the 2 years, 40% experienced flare, occurring on average at 11.7±7.0 months. Notably, 5.7% have US-PD flares without clinical signs. Analysis revealed Stage III disease and CRP as factors linked to a shorter time to flare.
Discussion and Conclusions: In patients with RA achieving LDA and US remission, frequent flares were observed with US remission over 2 years, but most maintained sustained remission. Baseline factors are essential for predicting flares, emphasizing continuous monitoring and personalized treatment to sustain remission and minimize flare risks in RA management.
(Copyright © 2024 Sociedad Española de Reumatología (SER), Colegio Mexicano de Reumatología (CMR) and Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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