<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_JoU.2022.0004_s_006"><h3>Objective</h3><p>The role of US-detected tenosynovitis (USTS) in the management of rheumatoid arthritis remains controversial. The aim of this study was to investigate whether tenosynovitis can predict a flare in rheumatoid arthritis patients in remission in a real-life cohort.</p></sec><sec id="j_JoU.2022.0004_s_007"><h3>Methods</h3><p>Rheumatoid arthritis patients from the Swiss Clinical Quality Management cohort were included in this study if they were in clinical remission, defined by 28-joint disease activity score (DAS28-ESR) &lt;2.6, and had an available B-mode tenosynovitis score. The patients were stratified according to the presence or absence of tenosynovitis (USTS+ vs. USTS–). Cox proportional hazard models were used for time-to-event analysis until the loss of remission, after adjustment for multiple confounders. The impact of baseline US performed early in remission and the advent of flares at different fixed time periods after baseline were investigated in sensitivity analysis.</p></sec><sec id="j_JoU.2022.0004_s_008"><h3>Results</h3><p>Tenosynovitis was detected in 10% of 402 rheumatoid arthritis patients in remission. At baseline, USTS+ patients in remission had significantly higher DAS28-ESR (mean (SD): USTS– 1.8 (0.5) versus USTS+ 2.0 (0.5); <italic>p</italic> = 0.0019) and higher additional disease activity parameters, such as physician global assessment, and simplified- and clinical-disease activity index. Joint synovitis detected by B-mode US was associated with tenosynovitis (mean (SD) 7.2 (6.3) in USTS– versus 9.0 (5.4) in USTS+, respectively; <italic>p</italic> = 0.02). A disease flare was observed in 69% of remission phases, with no differences in the time to loss of remission between USTS+ and USTS– groups.</p></sec><sec id="j_JoU.2022.0004_s_009"><h3>Conclusion</h3><p>While US-detected tenosynovitis was associated with higher disease activity parameters in rheumatoid arthritis patients in clinical remission, it was not able to predict a flare.</p></sec></abstract>

ObjectiveThe role of US-detected tenosynovitis (USTS) in the management of rheumatoid arthritis remains controversial. The aim of this study was to investigate whether tenosynovitis can predict a flare in rheumatoid arthritis patients in remission in a real-life cohort.MethodsRheumatoid arthritis patients from the Swiss Clinical Quality Management cohort were included in this study if they were in clinical remission, defined by 28-joint disease activity score (DAS28-ESR) <2.6, and had an available B-mode tenosynovitis score. The patients were stratified according to the presence or absence of tenosynovitis (USTS+ vs. USTS–). Cox proportional hazard models were used for time-to-event analysis until the loss of remission, after adjustment for multiple confounders. The impact of baseline US performed early in remission and the advent of flares at different fixed time periods after baseline were investigated in sensitivity analysis.ResultsTenosynovitis was detected in 10% of 402 rheumatoid arthritis patients in remission. At baseline, USTS+ patients in remission had significantly higher DAS28-ESR (mean (SD): USTS– 1.8 (0.5) versus USTS+ 2.0 (0.5); p = 0.0019) and higher additional disease activity parameters, such as physician global assessment, and simplified- and clinical-disease activity index. Joint synovitis detected by B-mode US was associated with tenosynovitis (mean (SD) 7.2 (6.3) in USTS– versus 9.0 (5.4) in USTS+, respectively; p = 0.02). A disease flare was observed in 69% of remission phases, with no differences in the time to loss of remission between USTS+ and USTS– groups.ConclusionWhile US-detected tenosynovitis was associated with higher disease activity parameters in rheumatoid arthritis patients in clinical remission, it was not able to predict a flare.

Does tenosynovitis of the hand detected by B-mode ultrasound predict loss of clinical remission in rheumatoid arthritis? Results from a real-life cohort

Journal of Ultrasonography

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

ObjectiveThe role of US-detected tenosynovitis (USTS) in the management of rheumatoid arthritis remains controversial. The aim of this study was to investigate...

Does tenosynovitis of the hand detected by B-mode ultrasound predict loss of clinical remission in rheumatoid arthritis? Results from a real-life cohort

Article Category: Research paper

Published Online: Feb 08, 2022

Page range: 21 - 27

Received: Aug 22, 2021

Accepted: Nov 26, 2021

DOI: https://doi.org/10.15557/JoU.2022.0004

Keywords
ultrasound, rheumatoid arthritis, tenosynovitis, remission, flare

© 2022 Raphael Micheroli, Almut Scherer, Kristina Bürki, Pascal Zufferey, Michael J. Nissen, Laure Brulhart, Burkhard Möller, Hans-Rudolf Ziswiler, Adrian Ciurea, Giorgio Tamborrini, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Does tenosynovitis of the hand detected by B-mode ultrasound predict loss of clinical remission in rheumatoid arthritis? Results from a real-life cohort

Article Category: Research paper

Published Online: Feb 08, 2022

Page range: 21 - 27

Received: Aug 22, 2021

Accepted: Nov 26, 2021

DOI: https://doi.org/10.15557/JoU.2022.0004

Keywordsultrasound, rheumatoid arthritis, tenosynovitis, remission, flare

© 2022 Raphael Micheroli, Almut Scherer, Kristina Bürki, Pascal Zufferey, Michael J. Nissen, Laure Brulhart, Burkhard Möller, Hans-Rudolf Ziswiler, Adrian Ciurea, Giorgio Tamborrini, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Keywords
ultrasound, rheumatoid arthritis, tenosynovitis, remission, flare