A comparison between traditional and modified composite remission scores and ultrasound imaging assessments in remission patients with rheumatoid arthritis
10.3760/cma.j.issn.1007-7480.2013.05.002
- VernacularTitle:类风湿关节炎临床缓解与超声影像学缓解的比较研究
- Author:
Qiang LI
;
Ping ZHU
;
Wen ZHAO
;
Qing HAN
- Publication Type:Journal Article
- Keywords:
Arthritis,rheumatoid;
Ultrasonography;
Comparative study
- From:
Chinese Journal of Rheumatology
2013;(5):293-297
- CountryChina
- Language:Chinese
-
Abstract:
Objective This study is aimed to assess the accuracy of clinical measurement of remission and investigate the association between clinical remission and the ultrasound imaging assessment of synovitis and infla'mation and to explore the value of ultrasound imaging in the evaluation of disease activity in the tight control of rheumatoid arthritis (RA).Methods RA patients with a disease activity score in 28 joints (DAS28-ESR) ≤2.6 for at least 3 months were stratified-using a standard and more stringent DAS28 and simplified disease activity index (SDAI) remission thresholds and the corresponding clinical and ultrasound imaging measures of synovitis were recorded.In addition,a retrospective analysis of disease activity in patients was carried out.Mann-Whitney U test,x2 test and multi-factor analysis of variance of repeated measurements were used for statistical analysis.Results A total of 48 cases were recruited.Thirty-seven cases (77％) met the ACR remission criteria,29 cases (60％) fulfilled the SDAI remission criteria,and 32 (67％) cases reached 2010 ACR/EULAR Boolean-based definition of remission criteria.There was no significant differences on imaging disease activity between SDAI remission patients and those who were not in remission (GS score,P=0.38; PD score,P=0.32).Seventy-nine percent patients in SDAI remission had GS and/or PD activity,but the difference was not statistically different when compared with patients who did not reach SDAI remission (P=0.29).Sustainable remission obtained in patients who also had achieved image remission could have longer remission time (P＜0.01) Conclusion Using more stringent clinical remission criteria could help in reducing residual inflammatory activity of,but ultrasound PD activities may not be significantly reduced.Integrated clinical indicators such as physical examination and imaging tools such as ultrasound can provide more accurate assessment of disease activity and could be used to guide treatment to achieve trueremission.
