PMID- 30285845
OWN - NLM
STAT- In-Process
LR  - 20190325
IS  - 1478-6362 (Electronic)
IS  - 1478-6354 (Linking)
VI  - 20
IP  - 1
DP  - 2018 Oct 3
TI  - Is synovial hypertrophy without Doppler activity sensitive to change? Post-hoc
      analysis from a rheumatoid arthritis ultrasound study.
PG  - 224
LID - 10.1186/s13075-018-1709-6 [doi]
AB  - BACKGROUND: To explore to what extent synovial hypertrophy in joints without
      Doppler activity is a sign of active disease, we investigated the sensitivity to 
      change of synovial hypertrophy without Doppler activity during biological
      disease-modifying antirheumatic drug (bDMARD) treatment in rheumatoid arthritis
      (RA) patients. METHOD: RA patients initiating or switching bDMARD treatment had
      ultrasound (US) performed on 36 joints at baseline, and at 3 and 6 months.
      Synovial hypertrophy by grayscale US and Doppler activity were graded separately 
      from 0 to 3 at the joint level for all time points. Changes in synovial
      hypertrophy in joints without Doppler activity during treatment were assessed and
      compared with changes in synovial hypertrophy in joints with Doppler activity.
      RESULTS: We included 151 patients (82.8% women, 80.1% seropositive for anticyclic
      citrullinated peptide) with a mean +/- standard deviation age of 51.4 +/- 13.2
      years, a disease duration of 9.9 +/- 7.9 years, and baseline Disease Activity
      Score 28-joint count C-reactive peptide (DAS28-CRP) of 4.14 +/- 1.32. At
      baseline, 44.8% of all joints examined (n = 5225) had synovial hypertrophy >/= 1 
      and 50.7% of these had synovial hypertrophy without Doppler activity. The
      improvement in synovial hypertrophy was similar in joints with and without
      Doppler activity but, when adjusting for the baseline score of synovial
      hypertrophy, joints with synovial hypertrophy without Doppler had a higher
      tendency towards a decrease than joints with synovial hypertrophy with Doppler
      activity independent of grade (3 months: p < 0.0001; 6 months: p = 0.0003).
      CONCLUSION: Joints with synovial hypertrophy without Doppler activity improve
      during treatment, independent of the grade. Thus, SH without Doppler activity is 
      not a sign of inactive disease. These findings indicate that joints with synovial
      hypertrophy without Doppler activity should also be taken in to account when
      assessing disease activity by US.
FAU - Terslev, Lene
AU  - Terslev L
AD  - Copenhagen Center for Arthritis Research and Center for Rheumatology and Spine
      Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Copenhagen, Denmark.
      terslev@dadlnet.dk.
FAU - Ostergaard, Mikkel
AU  - Ostergaard M
AD  - Copenhagen Center for Arthritis Research and Center for Rheumatology and Spine
      Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Copenhagen, Denmark.
AD  - Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
FAU - Sexton, Joe
AU  - Sexton J
AD  - Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
FAU - Hammer, Hilde Berner
AU  - Hammer HB
AD  - Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20181003
PL  - England
TA  - Arthritis Res Ther
JT  - Arthritis research & therapy
JID - 101154438
PMC - PMC6235232
OTO - NOTNLM
OT  - *Doppler
OT  - *Rheumatoid arthritis
OT  - *Sensitivity-to-change
OT  - *Synovitis
OT  - *Ultrasound
EDAT- 2018/10/05 06:00
MHDA- 2018/10/05 06:00
CRDT- 2018/10/05 06:00
PHST- 2018/06/07 00:00 [received]
PHST- 2018/08/28 00:00 [accepted]
PHST- 2018/10/05 06:00 [entrez]
PHST- 2018/10/05 06:00 [pubmed]
PHST- 2018/10/05 06:00 [medline]
AID - 10.1186/s13075-018-1709-6 [doi]
AID - 10.1186/s13075-018-1709-6 [pii]
PST - epublish
SO  - Arthritis Res Ther. 2018 Oct 3;20(1):224. doi: 10.1186/s13075-018-1709-6.