PMID- 28545509
OWN - NLM
STAT- MEDLINE
DCOM- 20180102
LR  - 20181113
IS  - 1478-6362 (Electronic)
IS  - 1478-6354 (Linking)
VI  - 19
IP  - 1
DP  - 2017 May 25
TI  - Ultrasound-detected bone erosion is a relapse risk factor after discontinuation
      of biologic disease-modifying antirheumatic drugs in patients with rheumatoid
      arthritis whose ultrasound power Doppler synovitis activity and clinical disease 
      activity are well controlled.
PG  - 108
LID - 10.1186/s13075-017-1320-2 [doi]
AB  - BACKGROUND: In the present study, we explored the risk factors for relapse after 
      discontinuation of biologic disease-modifying antirheumatic drug (bDMARD) therapy
      in patients with rheumatoid arthritis (RA) whose ultrasound power Doppler (PD)
      synovitis activity and clinical disease activity were well controlled. METHODS:
      In this observational study in clinical practice, the inclusion criteria were
      based on ultrasound disease activity and clinical disease activity, set as low or
      remission (Disease Activity Score in 28 joints based on erythrocyte sedimentation
      rate <3.2). Ultrasound was performed in 22 joints of bilateral hands at
      discontinuation for evaluating synovitis severity and presence of bone erosion.
      Patients with a maximum PD score </=1 in each joint were enrolled. Forty patients
      with RA were consecutively recruited (November 2010-March 2015) and discontinued 
      bDMARD therapy. Variables at the initiation and discontinuation of bDMARD therapy
      that were predictive of relapse during the 12 months after discontinuation were
      assessed. RESULTS: The median patient age was 54.5 years, and the median disease 
      duration was 3.5 years. Nineteen (47.5%) patients relapsed during the 12 months
      after the discontinuation of bDMARD therapy. Logistic regression analysis
      revealed that only the presence of bone erosion detected by ultrasound at
      discontinuation was predictive of relapse (OR 8.35, 95% CI 1.78-53.2, p = 0.006).
      No clinical characteristics or serologic biomarkers were significantly different 
      between the relapse and nonrelapse patients. The ultrasound synovitis scores did 
      not differ significantly between the groups. CONCLUSIONS: Our findings are the
      first evidence that ultrasound bone erosion may be a relapse risk factor after
      the discontinuation of bDMARD therapy in patients with RA whose PD synovitis
      activity and clinical disease activity are well controlled.
FAU - Kawashiri, Shin-Ya
AU  - Kawashiri SY
AD  - Department of Community Medicine, Nagasaki University Graduate School of
      Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
      shin-ya@hotmail.co.jp.
AD  - Department of Public Health, Nagasaki University Graduate School of Biomedical
      Sciences, Nagasaki, Japan. shin-ya@hotmail.co.jp.
AD  - Department of Immunology and Rheumatology, Nagasaki University Graduate School of
      Biomedical Sciences, Nagasaki, Japan. shin-ya@hotmail.co.jp.
FAU - Fujikawa, Keita
AU  - Fujikawa K
AD  - Department of Internal Medicine, Isahaya General Hospital, Isahaya, Japan.
FAU - Nishino, Ayako
AU  - Nishino A
AD  - Department of Immunology and Rheumatology, Nagasaki University Graduate School of
      Biomedical Sciences, Nagasaki, Japan.
AD  - Department of Center for Comprehensive Community Care Education, Nagasaki
      University Graduate School of Biomedical Sciences, Nagasaki, Japan.
FAU - Okada, Akitomo
AU  - Okada A
AD  - Department of Internal Medicine, Japanese Red Cross Nagasaki Genbaku Hospital,
      Nagasaki, Japan.
FAU - Aramaki, Toshiyuki
AU  - Aramaki T
AD  - Center for Rheumatic disease, Sasebo Chuo Hospital, Sasebo, Japan.
FAU - Shimizu, Toshimasa
AU  - Shimizu T
AD  - Department of Immunology and Rheumatology, Nagasaki University Graduate School of
      Biomedical Sciences, Nagasaki, Japan.
FAU - Umeda, Masataka
AU  - Umeda M
AD  - Department of Immunology and Rheumatology, Nagasaki University Graduate School of
      Biomedical Sciences, Nagasaki, Japan.
FAU - Fukui, Shoichi
AU  - Fukui S
AD  - Department of Immunology and Rheumatology, Nagasaki University Graduate School of
      Biomedical Sciences, Nagasaki, Japan.
FAU - Suzuki, Takahisa
AU  - Suzuki T
AD  - Department of Internal Medicine, Japanese Red Cross Nagasaki Genbaku Hospital,
      Nagasaki, Japan.
FAU - Koga, Tomohiro
AU  - Koga T
AD  - Department of Immunology and Rheumatology, Nagasaki University Graduate School of
      Biomedical Sciences, Nagasaki, Japan.
FAU - Iwamoto, Naoki
AU  - Iwamoto N
AD  - Department of Immunology and Rheumatology, Nagasaki University Graduate School of
      Biomedical Sciences, Nagasaki, Japan.
FAU - Ichinose, Kunihiro
AU  - Ichinose K
AD  - Department of Immunology and Rheumatology, Nagasaki University Graduate School of
      Biomedical Sciences, Nagasaki, Japan.
FAU - Tamai, Mami
AU  - Tamai M
AD  - Department of Immunology and Rheumatology, Nagasaki University Graduate School of
      Biomedical Sciences, Nagasaki, Japan.
FAU - Mizokami, Akinari
AU  - Mizokami A
AD  - Department of Internal Medicine, Isahaya General Hospital, Isahaya, Japan.
FAU - Nakamura, Hideki
AU  - Nakamura H
AD  - Department of Immunology and Rheumatology, Nagasaki University Graduate School of
      Biomedical Sciences, Nagasaki, Japan.
FAU - Origuchi, Tomoki
AU  - Origuchi T
AD  - Department of Immunology and Rheumatology, Nagasaki University Graduate School of
      Biomedical Sciences, Nagasaki, Japan.
FAU - Ueki, Yukitaka
AU  - Ueki Y
AD  - Department of Internal Medicine, Japanese Red Cross Nagasaki Genbaku Hospital,
      Nagasaki, Japan.
FAU - Aoyagi, Kiyoshi
AU  - Aoyagi K
AD  - Department of Public Health, Nagasaki University Graduate School of Biomedical
      Sciences, Nagasaki, Japan.
FAU - Maeda, Takahiro
AU  - Maeda T
AD  - Department of Community Medicine, Nagasaki University Graduate School of
      Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
FAU - Kawakami, Atsushi
AU  - Kawakami A
AD  - Department of Immunology and Rheumatology, Nagasaki University Graduate School of
      Biomedical Sciences, Nagasaki, Japan.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20170525
PL  - England
TA  - Arthritis Res Ther
JT  - Arthritis research & therapy
JID - 101154438
RN  - 0 (Antirheumatic Agents)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antirheumatic Agents/*therapeutic use
MH  - Arthritis, Rheumatoid/*diagnostic imaging/*drug therapy/pathology
MH  - Bone Diseases/*diagnostic imaging
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Recurrence
MH  - Risk Factors
MH  - Synovitis/*diagnostic imaging/drug therapy
MH  - Ultrasonography, Doppler
PMC - PMC5445491
OTO - NOTNLM
OT  - *Biologic disease-modifying antirheumatic drug
OT  - *Discontinuation
OT  - *RA
OT  - *Remission
OT  - *Rheumatoid arthritis
OT  - *Ultrasound
OT  - *bDMARD
EDAT- 2017/05/27 06:00
MHDA- 2018/01/03 06:00
CRDT- 2017/05/27 06:00
PHST- 2017/02/06 00:00 [received]
PHST- 2017/05/05 00:00 [accepted]
PHST- 2017/05/27 06:00 [entrez]
PHST- 2017/05/27 06:00 [pubmed]
PHST- 2018/01/03 06:00 [medline]
AID - 10.1186/s13075-017-1320-2 [doi]
AID - 10.1186/s13075-017-1320-2 [pii]
PST - epublish
SO  - Arthritis Res Ther. 2017 May 25;19(1):108. doi: 10.1186/s13075-017-1320-2.