PMID- 30285845
OWN - NLM
STAT- MEDLINE
DCOM- 20190718
LR  - 20190718
IS  - 1478-6362 (Electronic)
IS  - 1478-6354 (Print)
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]
LID - 224
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
SB  - IM
MH  - Adult
MH  - Aged
MH  - Arthritis, Rheumatoid/blood/*diagnostic imaging/*epidemiology
MH  - Cohort Studies
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Synovitis/blood/*diagnostic imaging/*epidemiology
MH  - *Ultrasonography, Doppler
PMC - PMC6235232
OTO - NOTNLM
OT  - Doppler
OT  - Rheumatoid arthritis
OT  - Sensitivity-to-change
OT  - Synovitis
OT  - Ultrasound
COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: The study was approved by the 
      Regional Committee for Medical and Health Research Ethics, South-East Norway, and 
      all patients gave written consent according to the Declaration of Helsinki. 
      CONSENT FOR PUBLICATION: Not applicable. COMPETING INTERESTS: LT declares 
      speakers fees from Roche, MSD, BMS, Pfizer, AbbVie, Novartis, and Janssen. MO 
      declares research support and/or consultancy/speaker fees from Abbvie, BMS, 
      Boehringer-Ingelheim, Celgene, Eli-Lilly, Centocor, GSK, Hospira, Janssen, Merck, 
      Mundipharma, Novartis, Novo, Orion, Pfizer, Regeneron, Roche, Takeda, UCB, and 
      Wyeth. HBH declares study grants from AbbVie/Pfizer and Roche. JS declares that 
      he has no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral 
      with regard to jurisdictional claims in published maps and institutional 
      affiliations.
EDAT- 2018/10/05 06:00
MHDA- 2019/07/19 06:00
PMCR- 2018/10/03
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- 2019/07/19 06:00 [medline]
PHST- 2018/10/03 00:00 [pmc-release]
AID - 10.1186/s13075-018-1709-6 [pii]
AID - 1709 [pii]
AID - 10.1186/s13075-018-1709-6 [doi]
PST - epublish
SO  - Arthritis Res Ther. 2018 Oct 3;20(1):224. doi: 10.1186/s13075-018-1709-6.