AB0188 COMPARISON OF COMPOSITE INDICES FOR DETECTING REMISSION ON ULTRASOUND

• Published in: Annals of the rheumatic diseases Vol. 79; no. Suppl 1; pp. 1393 - 1394
• Main Authors: Fakhfakh, R., El Amri, N., Baccouche, K., Zeglaoui, H., Bouajina, E.
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2020
• Subjects: Boolean; Clinical trials; Doppler effect; Hypertrophy; Joint diseases; Patients; Remission; Remission (Medicine); Rheumatoid arthritis; Rheumatology; Sex ratio; Synovitis; Tendons; Tenosynovitis; Ultrasonic imaging; Ultrasound
• DOI: 10.1136/annrheumdis-2020-eular.5904
• ISSN: 0003-4967

Background:Several studies have shown the greater sensitivity of ultrasound (US) to detect B-mode synovitis and synovial Doppler activity in a high percentage of rheumatoid Arthritis (RA) patients in clinical remission, assessed by different composite indices.Objectives:The aim of the study was to compare the accuracy of composite indices to detect remission in ultrasound B-mode and power Doppler (PD) in RA patients that are in remission according to the DAS28 ESR.Methods:Cross-sectional study including patients with RA in clinical remission defined by: DAS28ESR ≤ 2.6, without disease flare or changes in therapy in the previous 6 months. Each patient underwent B-mode and PD assessments of 36 joints and 20 tendons in the Rheumatology Department over a period of 6 month. B-mode and PD signal for synovitis and tenosynovitis were defined according to the Outcome Measures in Rheumatology Clinical Trials (OMERACT). A global score for B-mode and a global score for PD signal were calculated for each patient. The DAS28, CDAI, SDAI and the Boolean 2010 ACR/EULAR remission criteria were compared.Results:Thirty two patients were enrolled, the mean age was 53.7±13.4 and the sex ratio M/F was 0.3. The mean disease duration was 15.0 years ± 8.8. According to the SDAI, 68.8% of patients were in remission. These were lower for the CDAI (62.5%) and the Boolean criteria (23.3%). Synovial hypertrophy and tenosynovitis in B mode was detected in 100% with the Boolean remission criteria, in 93.8% with a DAS28, in 90.9% with a SDAI ≤ 3.3 and in 90% with a CDAI ≤ 2.8 (p>0.05). The PD signal was detected in 62.5% with a DAS28, in 59.1% with a SDAI ≤ 3.3, in 57.1% with the Boolean remission criteria and in 55.1% with a CDAI≤ 2.8 (p>0.05). The mean B-mode global score was higher for the DAS28 ESR (8.2±6) and lower for the Boolean remission criteria (6.2 ±5.4). For a CDAI ≤ 2.8, the mean global score for B-mode was 7.6 ±5.9 and for a SDAI ≤ 3.3, it was 7.4±5.7. The median PD global score was similar for the DAS28, SDAI≤ 3.3 and Boolean remission criteria (1[0-12]). It was higher for a CDAI ≤ 2.8 (1.5 [0-12]). The global score for PD signal was correlated with DAS28 ESR (r: 0.42 p: 0.02). There were no significant correlations between the other indices and the mode B and PD global scores.Conclusion:The CDAI least detected subclinical synovitis and tenosynovitis in B mode and in power Doppler signal but it showed higher scores of power Doppler.References:[1]Merve Ozata Olmez, Esen Kasapoglu Gunal, Sibel Bakirci Ureyen and al. Comparison of composite indices with global synovitis score on ultrasound for detecting remission. Clinical Rheumatology 2017. doi.org/10.1007/s10067-017-3925-xDisclosure of Interests:None declared