Inclusion of Synovial Tissue–Derived Characteristics in a Nomogram for the Prediction of Treatment Response in Treatment‐Naive Rheumatoid Arthritis Patients
| Autor: | Laura Bui, Clara Di Mario, Giusy Peluso, Alice Mannocci, Francesco Federico, A. Capacci, Luca Petricca, Elisa Gremese, Maria Rita Gigante, Stefano Alivernini, Dario Bruno, Anna Laura Fedele, Barbara Tolusso, Giuseppe La Torre, Marco Gessi, S. Perniola, Gianfranco Ferraccioli |
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| Rok vydání: | 2021 |
| Předmět: |
Male
musculoskeletal diseases medicine.medical_specialty Inflammatory arthritis Full Length Immunology Arthritis Rheumatoid Arthritis Osteoarthritis Severity of Illness Index Arthritis Rheumatoid Psoriatic arthritis Rheumatology Synovitis Internal medicine Biopsy medicine Humans Immunology and Allergy Aged Ultrasonography medicine.diagnostic_test business.industry Remission Induction Synovial Membrane Middle Aged Nomogram medicine.disease Nomograms Antirheumatic Agents Rheumatoid arthritis Female business |
| Zdroj: | Arthritis & Rheumatology (Hoboken, N.j.) |
| ISSN: | 2326-5205 2326-5191 |
| Popis: | Objective This study applied a synovitis score obtained during routine care from ultrasound (US)–guided biopsies of synovial tissue (ST) in patients with rheumatoid arthritis (RA) and patients with other inflammatory and noninflammatory joint diseases to identify pretreatment synovial biomarkers associated with disease characteristics, and to integrate the findings into a multiparameter nomogram for use in baseline prediction of diagnosis and treatment response in treatment‐naive rheumatoid arthritis (RA) patients. Methods The study enrolled a total of 1,015 patients with various autoimmune diseases (545 patients with RA, 167 patients with psoriatic arthritis [PsA], 199 patients with undifferentiated peripheral inflammatory arthritis [UPIA], 18 patients with crystal‐induced arthritis, 26 patients with connective tissue diseases, and 60 patients with osteoarthritis [OA] [as part of the SYNGem cohort]). All patients underwent a US‐guided ST biopsy at baseline, and patients were then stratified according to disease phase. The KSS, along with disease characteristics and clinical outcomes, were incorporated into a nomogram for prediction of achievement of clinical remission in RA patients who were previously naive to treatment. In patients in whom a treat‐to‐target strategy was applied, remission was defined as change in the Disease Activity Score in 28 joints (DAS28) at 6 months after treatment initiation. Results The KSS significantly differed among RA patients, as well as PsA patients and UPIA patients, when compared to OA patients. In RA, the KSS directly correlated with the DAS28 and was related to autoantibody positivity in treatment‐naive RA patients. Moreover, at baseline, treatment‐naive RA patients achieving 6‐month remission according to DAS28 had a lower KSS, shorter duration of symptoms (very early RA [VERA]), and lower disease activity than treatment‐naive RA patients not achieving remission according to DAS28. Results of logistic regression analysis identified the following synergistic predictive factors of achievement of DAS28‐based disease remission at 6 months: having a short disease duration (VERA), not having high disease activity, and having a KSS of |
| Databáze: | OpenAIRE |
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