Key result
Short disease duration, methotrexate use, and low global scores predict clinical remission in ultrasound-remitted RA.
Why the study?
The study aimed to identify baseline factors differentiating RA patients achieving ultrasound remission versus clinical remission, and to determine factors contributing to discrepancies between them.
What baseline factors differentiate rheumatoid arthritis patients who achieve both clinical and ultrasound remission from those who achieve only ultrasound remission?
Cohort (n=248)
Yes
What baseline factors differentiate rheumatoid arthritis patients who achieve both clinical and ultrasound remission from those who achieve only ultrasound remission?
In RA patients treated with bDMARDs, high baseline patient global assessment scores and long disease duration predict a failure to achieve clinical remission despite achieving ultrasound remission.
Answers are grounded in this paper and cite their sources.
Identifies predictors of dual remission in bDMARD-treated RA; leaves open whether targeting these factors improves outcomes.
Objectives: Using multicentre ultrasound (US) cohort data among patients with rheumatoid arthritis (RA), we aimed to identify baseline factors that permit differentiation between two patient cohorts achieving US remission and clinical remission, and to determine the factors contributing to the discrepancy.Method: We reviewed 248 Japanese patients diagnosed with RA who underwent treatment with biological disease-modifying anti-rheumatic drugs at 13 centres. We performed US assessments of the synovia of 22 joints. We assessed the percentages of patients with clinical remission and US remission, defined as total power Doppler scores of 0 at 12 months.Results: The 87 patients who achieved US remission were divided into a group that achieved both clinical and US remission (n = 53) and a group that achieved US remission only (n = 34). Baseline factors that were significantly and independently associated with clinical remission at 12 months among patients who also achieved US remission included short disease duration, the presence of concomitant methotrexate use, and low patient global assessment score (p < 0.05, p < 0.05, and p < 0.005, respectively).Conclusions: RA patients with baseline high patient global assessment scores and long disease duration at baseline were unlikely to achieve clinical remission even after achieving US remission. Objective joint assessments using US provide additional information of potential importance for the management of RA.
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Endo et al. (2021) conducted a cohort in Rheumatoid arthritis (n=248). Short disease duration, concomitant methotrexate use, and low patient global assessment score vs. Long disease duration, no methotrexate use, and high patient global assessment score was evaluated on Clinical remission at 12 months among patients achieving ultrasound remission (p=<0.05, <0.05, and <0.005). Among RA patients achieving ultrasound remission, short disease duration, concomitant methotrexate use, and low patient global assessment score were significantly associated with clinical remission.
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