Your browser doesn't support javascript.
loading
Predictive value of tender joints compared to synovitis for structural damage in rheumatoid arthritis.
Cheung, Peter P; Mari, Karine; Devauchelle-Pensec, Valérie; Jousse-Joulin, Sandrine; D'Agostino, Maria Antonietta; Chalès, Gérard; Gaudin, Philippe; Mariette, Xavier; Saraux, Alain; Dougados, Maxime.
Afiliación
  • Cheung PP; Division of Rheumatology , National University Hospital , Singapore , Singapore.
  • Mari K; RCTs , Lyon , France.
  • Devauchelle-Pensec V; Department of Rheumatology, CHU de la Cavale Blanche, Boulevard Tanguy Prigent, Brest, France; EA 2216, INSERM ESPRI, ERI29 Université Bretagne Occidentale, Brest, France.
  • Jousse-Joulin S; Department of Rheumatology, CHU de la Cavale Blanche, Boulevard Tanguy Prigent, Brest, France; EA 2216, INSERM ESPRI, ERI29 Université Bretagne Occidentale, Brest, France.
  • D'Agostino MA; Department of Rheumatology , APHP, Ambrose-Paré, Versailles-Saint Quentin en Yvelines University , Boulogne-Billancourt , France.
  • Chalès G; Department of Rheumatology , Hôpital Sud, CHU Rennes , Rennes , France.
  • Gaudin P; Department of Rheumatology , University Hospital, Grenoble, Hôpital Sud , Echirolles , France.
  • Mariette X; Department of Rheumatology , Hôpitaux Universitaires Paris-Sud; Université Paris-Sud; INSERM U1012; Le Kremlin Bicêtre , Paris , France.
  • Saraux A; Department of Rheumatology, CHU de la Cavale Blanche, Boulevard Tanguy Prigent, Brest, France; EA 2216, INSERM ESPRI, ERI29 Université Bretagne Occidentale, Brest, France.
  • Dougados M; Department of Rheumatology , Hôpital Cochin , Paris , France.
RMD Open ; 2(1): e000205, 2016.
Article en En | MEDLINE | ID: mdl-27042336
ABSTRACT

OBJECTIVE:

To evaluate the predictive value of tender joints compared to synovitis for structural damage in rheumatoid arthritis (RA).

METHODS:

A post hoc analysis was performed on a prospective 2-year study of 59 patients with active RA starting on antitumour necrosis factor (TNF). Tenderness and synovitis was assessed clinically at baseline, followed by blinded ultrasound assessment (B-mode and power Doppler ultrasound (PDUS)) on the hands and feet (2 wrists, 10 metacarpophalangeal, 10 proximal interphalangeal and 10 metatarsophalangeal (MTP) joints). Radiographs of these joints were performed at baseline and at 2 years. The risk of radiographic progression with respect to the presence of baseline tenderness or synovitis, as well as its persistence (after 4 months of anti-TNF), was estimated by OR (95% CI).

RESULTS:

Baseline tender joints were the least predictive for radiographic progression (OR=1.53 (95% CI 1.02 to 2.29) p<0.04), when compared to synovitis (clinical OR=2.08 (95% CI 1.39 to 3.11) p<0.001 or PDUS OR=1.80 (95% CI 1.20 to 2.71) p=0.005, respectively). Tender joints with the presence of synovitis were predictive of radiographic progression (OR=1.89 (95% CI 1.25 to 2.85) p=0.002), especially seen in the MTP joints. Non-tender joints with no synovitis were negatively predictive (OR=0.57 (95% CI 0.39 to 0.82) p=0.003). Persistence of tender joints was negatively predictive (OR=0.38 (95% CI 0.18 to 0.78) p=0.009) while persistence of synovitis was predictive (OR=2.41 (95% CI 1.24 to 4.67) p=0.01) of radiographic progression.

CONCLUSIONS:

Synovitis is better than tenderness to predict for subsequent structural progression. However, coexistence of tenderness and synovitis at the level of an individual joint is predictive of structural damage, particularly in the MTP joints. TRIAL REGISTRATION NUMBER NCT00444691.
Palabras clave

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies Idioma: En Revista: RMD Open Año: 2016 Tipo del documento: Article País de afiliación: Singapur

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies Idioma: En Revista: RMD Open Año: 2016 Tipo del documento: Article País de afiliación: Singapur