Ultrasound Remission Research Articles

THU0187 Does Ultrasound-Scored Synovitis Depend on the Pharmacokinetics of Subcutaneous Anti-TNF Agents in Patients with Rheumatoid Arthritis?

BackgroundMany observational studies have shown responsiveness of ultrasound (US)-detected synovitis in rheumatoid arthritis (RA) patients, most of them using biologic therapies. However, these studies have not taken into consideration in...

SAT0193 Utility of Ultrasound in the Nuffield Orthopaedic Centre Emergency Rheumatology Clinic: Survey of Clinical Effectiveness

BackgroundThe aim of the survey was to evaluate the impact of clinic-based musculoskeletal ultrasonography (MSUS) on diagnosis and management of cases seen in the Nuffield Orthopaedic Hospital emergency rheumatology clinic.ObjectivesPrimary:...

EVALUATION OF ULTRASOUND REMISSION CRITERIA IN PATIENTS WITH RHEUMATOID ARTHRITIS DURING TOCILIZUMAB THERAPY

Objective: to study the association of ultrasound (US) remission criteria with the clinical and laboratory indicators of inflammatory activity, functional status, and X-ray changes in patients with rheumatoid arthritis (RA) during tocilizumab (TCZ) therapy. Subjects and methods. The trial included 36 patients with RA (meeting the 1987 American College of Rheumatology (ACR) criteria) who had received TCZ for 6 months. The authors made a clinical and laboratory assessment of RA activity (DAS28-CRP, and SDAI), functional impairments (HAQ index) and US verification of wrist joint synovitis (a Voluson-i device, GE, 4-13-MHz linear transducer) at baseline and 6 months after therapy. No signs of grey-scale (B-mode) and power Doppler (PD) synovitis (B = 0; PD = 0) or minimal B-mode synovitis, and not more one PD hypervascular signal (В ≤1; PD ≤1) were arbitrarily taken as US remission criteria. Destruction changes were evaluated by hand and foot X-ray using the Sharp method modified by van der Heijde (SHS). Results. After 6 months of therapy, about 80% of the patients in clinical remission retained moderate or significant synovitis, as evidenced by US studies. There were no clinical differences in clinical activity indices and functional impairments between the patients who were and were not in US remission (p > 0.05). The 12-month follow-up SHS score was significantly higher with the preservation of 6-month therapy signs of B-mode synovitis and PD hypervascularization (of not more than one signal) than that in US remission (p 0.05). Conclusion. Subclinical synovitis is observed even in clinical remission of RA. Destruction progression is significantly related to synovitis persistence, as shown by ultrasonography.

Disparity between ultrasound and clinical findings in psoriatic arthritis

ObjectiveTo investigate the association between psoriatic arthritis (PsA)-specific clinical composite scores and ultrasound-verified pathology as well as comparison of clinical and ultrasound definitions of remission.MethodsWe performed a prospective study on...

AB0750 Comparative study between physical and ultrasound examination in rheumatoid arthritis patients with low disease activity or in remission

BackgroundImaging data indicates that Rheumatoid Arthritis (RA) patients in clinical remission (CR) may present persistent sub-clinical inflammatory activity. Positive Power Doppler Ultrasonography (PDUS) signal in joints is considered to be...

OP0275 Persistence of ultrasound synovitis in the patients fullfiling the DAS and/or the new ACR/EULAR RA remission definitions: Results of the sonar score applied to the patients of the SCQM cohort

BackgroundRemission is nowadays the primary goal of RA treatment, As the traditional remission criterion of DAS28 <2.6 seemed to be not stringent enough, the EULAR and ACR have proposed a...

FRI0130 Change in disease outcomes after implementation of treat to target, including evaluation of power doppler ultrasound remission

BackgroundThe 2010 treatment to target guidelines recommend frequent assessment to achieve a pre-defined target (ideally remission) in early rheumatoid arthritis (RA) [1]. Power Doppler (PD) ultrasound has the ability to...

SAT0474 Differences of clinical and ultrasound (US) remission in rheumatoid arthritis (RA) depend on the stringency of the us methodology

BackgroundProgression of joint damage in RA occurs primarily in joints that are clinically swollen, and repair is seen only in joints with no clinical swelling.1;2 On the other hand, joints...

THU0109 Treating to target ultrasound with clinical remission better effects than clinical remission in RRP

BackgroundTreatment of rheumatoid arthritis (RA) should aim at full remission. However,recent publications described rapid radiographic progression (RRP) existed despite initial biologics and methotrexate combination therapy in early RA. In RRP,...

Is surgery necessary after complete clinical remission following neoadjuvant chemotherapy for early breast cancer?

This retrospective analysis aimed to identify whether breast cancer patients receiving radiotherapy alone following a complete clinical remission (cCR) to neoadjuvant chemotherapy had a worse outcome than those treated with surgery. One hundred thirty-six patients who had achieved a cCR to neoadjuvant chemotherapy for early breast cancer were identified from a prospectively maintained database of 453 patients. Of these, 67 patients had undergone surgery as their primary locoregional therapy, and 69 patients had radiotherapy alone. Outcome was assessed in relation to local recurrence-free survival, disease-free survival, and overall survival. Median follow-up was 63 months in the surgery group and 87 months in the no surgery group. Prognostic characteristics were well balanced between the two groups. For surgery and no surgery, respectively, there were no significant differences in disease-free survival or overall survival (5-year, 74% v 76%; 10-year, 60% v 70%, P =.9) between the two groups. There was a nonsignificant trend toward increased locoregional-only recurrence for the no surgery group (21% v 10% at 5 years; P =.09), but no long-term failures of local control. Patients in the no surgery group who also achieved an ultrasound complete remission had a 5-year local recurrence rate of only 8%. In patients achieving a cCR to neoadjuvant chemotherapy, radiotherapy alone achieve survival rates as good as with surgery, but with higher local recurrence rates. Ultrasound may identify a low recurrence rate subgroup for assessing no surgery in a prospective trial.