Evaluation and characteristics of subclinical synovitis in patients with clinical remission of rheumatoid arthritis

Yanhua Wang; Jing Luo; Xiuyuan Feng; Lingfei MO; Dan PU; Xiaohong LV; Zhiming Hao; Lan HE

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Evaluation and characteristics of subclinical synovitis in patients with clinical remission of rheumatoid arthritis

VernacularTitle:临床缓解类风湿关节炎患者亚临床滑膜炎的评估及特征分析
Author: Yanhua WANG ¹ ; Jing LUO ¹ ; Xiuyuan FENG ¹ ; Lingfei MO ¹ ; Dan PU ¹ ; Xiaohong LV ¹ ; Zhiming HAO ¹ ; Lan HE ¹
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1. Department of Rheumatology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
Publication Type:Journal Article
Keywords: rheumatoid arthritis; musculoskeletal ultrasound; clinical remission; subclinical synovitis
From: Journal of Xi'an Jiaotong University(Medical Sciences) 2021;42(1):93-98
CountryChina
Language:Chinese
Abstract: 【Objective】 To evaluate musculoskeletal ultrasound (MSUS) detected subclinical synovitis of rheumatoid arthritis (RA) with different clinical remission criteria so as to explore the clinical characteristics of subclinical synovitis. 【Methods】 Forty-six consecutive patients with RA in clinical remission [disease activity score-28 (DAS28)≤2.6] underwent clinical and MSUS examinations at baseline and 1 year follow-up. Clinical remission was defined according to the DAS28 using the erythrocyte sedimentation rate (DAS28-ESR) and C-reactive protein level (DAS28-CRP), clinical disease activity index (CDAI), simplified clinical disease activity index (SDAI), and American College of Rheumatology/European League Against Rheumatism criteria Boolean (ACR/EULAR criteria). Subclinical synovitis was assessed by MSUS. Differences between the subclinical synovitis and non-subclinical synovitis groups were analyzed. 【Results】 The percentages of patients who achieved DAS28-ESR, DAS28-CRP, CDAI, SDAI, and ACR/EULAR remission at baseline and 1 year were 97.8%, 95.6%, 67.4%, 54.3%, 52.2% and 91.3%, 93.5%, 54.3%, 50.0%, and 45.6%, respectively. Subclinical synovitis was detected in 55.5%, 54.5%, 45.2%, 40.0%, 41.6% and 45.2%, 46.5%, 40.0%, 39.1%, and 38.1% of these patients, respectively. There were 45.6% and 41.3% patients who fulfilled all the criteria, yet 38.1% and 36.8% still had evidence of subclinical synovitis at baseline and 1 year. Compared with the patients without subclinical synovitis, those with subclinical synovitis had a significantly positive rate of anti-CCP antibody and a higher disease activity score at baseline (P<0.05). 【Conclusion】 MSUS detected subclinical synovitis is common. The positive anti-CCP antibody and higher disease activity score at baseline may be related to subclinical synovitis in patients with RA in clinical remission.