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Ultrasound-detected activity in rheumatoid arthritis on methotrexate therapy: Which joints and tendons should be assessed to predict unstable remission?

To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1007/s00296-015-3409-8 Byline: Iustina Janta (1), Lara Valor (1), Inmaculada Torre (1), Lina Martinez-Estupinan (1), Juan Carlos Nieto (1), Juan Gabriel Ovalles-Bonilla (1),... Full description

Journal Title: Rheumatology international March 2016, Vol.36(3), pp.387-396
Main Author: Janta, Iustina
Other Authors: Valor, Lara , De La Torre, Inmaculada , Martínez-Estupiñán, Lina , Nieto, Juan Carlos , Ovalles-Bonilla, Juan Gabriel , Martínez-Barrio, Julia , Bello, Natalia , Hinojosa, Michelle , Montoro, María , González, Carlos Manuel , López-Longo, Javier , Monteagudo
Format: Electronic Article Electronic Article
Language: English
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ID: E-ISSN: 1437-160X ; DOI: 10.1007/s00296-015-3409-8
Link: http://search.proquest.com/docview/1767070110/?pq-origsite=primo
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title: Ultrasound-detected activity in rheumatoid arthritis on methotrexate therapy: Which joints and tendons should be assessed to predict unstable remission?
format: Article
creator:
  • Janta, Iustina
  • Valor, Lara
  • De La Torre, Inmaculada
  • Martínez-Estupiñán, Lina
  • Nieto, Juan Carlos
  • Ovalles-Bonilla, Juan Gabriel
  • Martínez-Barrio, Julia
  • Bello, Natalia
  • Hinojosa, Michelle
  • Montoro, María
  • González, Carlos Manuel
  • López-Longo, Javier
  • Monteagudo
subjects:
  • Adult–Therapeutic Use
  • Aged–Diagnostic Imaging
  • Aged, 80 and Over–Drug Therapy
  • Antirheumatic Agents–Diagnostic Imaging
  • Arthritis, Rheumatoid–Drug Effects
  • Chi-Square Distribution–Therapeutic Use
  • Disability Evaluation–Diagnostic Imaging
  • Female–Drug Therapy
  • Humans–Diagnostic Imaging
  • Joints–Drug Effects
  • Logistic Models–Diagnosis
  • Male–Diagnostic Imaging
  • Methotrexate–Diagnostic Imaging
  • Middle Aged–Diagnostic Imaging
  • Multivariate Analysis–Diagnostic Imaging
  • Odds Ratio–Diagnostic Imaging
  • Predictive Value of Tests–Diagnostic Imaging
  • Prospective Studies–Diagnostic Imaging
  • Recurrence–Diagnostic Imaging
  • Remission Induction
ispartof: Rheumatology international, March 2016, Vol.36(3), pp.387-396
description: To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1007/s00296-015-3409-8 Byline: Iustina Janta (1), Lara Valor (1), Inmaculada Torre (1), Lina Martinez-Estupinan (1), Juan Carlos Nieto (1), Juan Gabriel Ovalles-Bonilla (1), Julia Martinez-Barrio (1), Natalia Bello (1), Michelle Hinojosa (1), Maria Montoro (1), Carlos Manuel Gonzalez (1), Javier Lopez-Longo (1), Indalecio Monteagudo (1), Luis Carreno (1), Esperanza Naredo (1) Keywords: Ultrasound; Doppler; Synovitis; Tenosynovitis; Rheumatoid arthritis; Remission Abstract: The aim of the study was to investigate the predictive value of different reduced joint ultrasound (US) assessments of synovitis and tenosynovitis in relation to unstable remission in a cohort of rheumatoid arthritis (RA) patients on methotrexate therapy. Forty-seven RA patients (38 women, 9 men), being treated with methotrexate (MTX), in clinical remission as judged by their consultant rheumatologist were evaluated for disease activity according to the Disease Activity Score (DAS) 28 at baseline and 6 months. Sustained remission and unstable remission were defined according to the baseline and 6-month DAS28 and changes in RA therapy during the follow-up. Each patient underwent at baseline a B-mode and power Doppler (PD) assessment of 44 joints and 20 tendons/tendon compartments by a rheumatologist blinded to the clinical and laboratory data. B-mode synovial hypertrophy (SH), synovial PD signal, B-mode tenosynovitis, and Doppler tenosynovitis were scored 0--3. The presence and index of synovial PD signal in 44 joints [odds ratio (OR) 8.21 (p = 0.016) and OR 2.20 (p = 0.049), respectively] and in 12 joints [OR 5.82 (p = 0.041) and OR 4.19 (p = 0.020), respectively], the presence of SH in wrist and MCP joints [OR 4.79 (p = 0.045)], and the presence of synovial PD signal in wrist--MCP--ankle--MTP joints [OR 4.62 (p = 0.046)] were predictors of unstable remission. The 12-joint or wrist--hand--ankle--MTP US assessments can predict unstable remission in RA patients in apparent clinical remission being treated with MTX. Author Affiliation: (1) Department of Rheumatology, Faculty of Medicine, Hospital General Universitario Gregorio Maranon, Complutense University, Doctor Esquerdo 46, 28007, Madrid, Spain Article History: Registration Date: 12/12/2015 Received Date: 31/08/2015 Accepted Date: 12/12/2015 Online Date: 28/12/2015
language: eng
source:
identifier: E-ISSN: 1437-160X ; DOI: 10.1007/s00296-015-3409-8
fulltext: fulltext
issn:
  • 1437160X
  • 1437-160X
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titleUltrasound-detected activity in rheumatoid arthritis on methotrexate therapy: Which joints and tendons should be assessed to predict unstable remission?
creatorJanta, Iustina ; Valor, Lara ; De La Torre, Inmaculada ; Martínez-Estupiñán, Lina ; Nieto, Juan Carlos ; Ovalles-Bonilla, Juan Gabriel ; Martínez-Barrio, Julia ; Bello, Natalia ; Hinojosa, Michelle ; Montoro, María ; González, Carlos Manuel ; López-Longo, Javier ; Monteagudo
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ispartofRheumatology international, March 2016, Vol.36(3), pp.387-396
identifierE-ISSN: 1437-160X ; DOI: 10.1007/s00296-015-3409-8
subjectAdult–Therapeutic Use ; Aged–Diagnostic Imaging ; Aged, 80 and Over–Drug Therapy ; Antirheumatic Agents–Diagnostic Imaging ; Arthritis, Rheumatoid–Drug Effects ; Chi-Square Distribution–Therapeutic Use ; Disability Evaluation–Diagnostic Imaging ; Female–Drug Therapy ; Humans–Diagnostic Imaging ; Joints–Drug Effects ; Logistic Models–Diagnosis ; Male–Diagnostic Imaging ; Methotrexate–Diagnostic Imaging ; Middle Aged–Diagnostic Imaging ; Multivariate Analysis–Diagnostic Imaging ; Odds Ratio–Diagnostic Imaging ; Predictive Value of Tests–Diagnostic Imaging ; Prospective Studies–Diagnostic Imaging ; Recurrence–Diagnostic Imaging ; Remission Induction
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descriptionTo access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1007/s00296-015-3409-8 Byline: Iustina Janta (1), Lara Valor (1), Inmaculada Torre (1), Lina Martinez-Estupinan (1), Juan Carlos Nieto (1), Juan Gabriel Ovalles-Bonilla (1), Julia Martinez-Barrio (1), Natalia Bello (1), Michelle Hinojosa (1), Maria Montoro (1), Carlos Manuel Gonzalez (1), Javier Lopez-Longo (1), Indalecio Monteagudo (1), Luis Carreno (1), Esperanza Naredo (1) Keywords: Ultrasound; Doppler; Synovitis; Tenosynovitis; Rheumatoid arthritis; Remission Abstract: The aim of the study was to investigate the predictive value of different reduced joint ultrasound (US) assessments of synovitis and tenosynovitis in relation to unstable remission in a cohort of rheumatoid arthritis (RA) patients on methotrexate therapy. Forty-seven RA patients (38 women, 9 men), being treated with methotrexate (MTX), in clinical remission as judged by their consultant rheumatologist were evaluated for disease activity according to the Disease Activity Score (DAS) 28 at baseline and 6 months. Sustained remission and unstable remission were defined according to the baseline and 6-month DAS28 and changes in RA therapy during the follow-up. Each patient underwent at baseline a B-mode and power Doppler (PD) assessment of 44 joints and 20 tendons/tendon compartments by a rheumatologist blinded to the clinical and laboratory data. B-mode synovial hypertrophy (SH), synovial PD signal, B-mode tenosynovitis, and Doppler tenosynovitis were scored 0--3. The presence and index of synovial PD signal in 44 joints [odds ratio (OR) 8.21 (p = 0.016) and OR 2.20 (p = 0.049), respectively] and in 12 joints [OR 5.82 (p = 0.041) and OR 4.19 (p = 0.020), respectively], the presence of SH in wrist and MCP joints [OR 4.79 (p = 0.045)], and the presence of synovial PD signal in wrist--MCP--ankle--MTP joints [OR 4.62 (p = 0.046)] were predictors of unstable remission. The 12-joint or wrist--hand--ankle--MTP US assessments can predict unstable remission in RA patients in apparent clinical remission being treated with MTX. Author Affiliation: (1) Department of Rheumatology, Faculty of Medicine, Hospital General Universitario Gregorio Maranon, Complutense University, Doctor Esquerdo 46, 28007, Madrid, Spain Article History: Registration Date: 12/12/2015 Received Date: 31/08/2015 Accepted Date: 12/12/2015 Online Date: 28/12/2015
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titleUltrasound-detected activity in rheumatoid arthritis on methotrexate therapy: Which joints and tendons should be assessed to predict unstable remission?
authorJanta, Iustina ; Valor, Lara ; De La Torre, Inmaculada ; Martínez-Estupiñán, Lina ; Nieto, Juan Carlos ; Ovalles-Bonilla, Juan Gabriel ; Martínez-Barrio, Julia ; Bello, Natalia ; Hinojosa, Michelle ; Montoro, María ; González, Carlos Manuel ; López-Longo, Javier ; Monteagudo
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