SAT0131 The role of ultrasound for the assessment of patients with active rheumatoid arthritis. (12th June 2018)

• Record Type: Journal Article
• Authors: Farietta, S.; Castillo, E.; Buitrago-Garcia, D.; Villarreal, L.; Santos-Moreno, P.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 927
• Page End: 928
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.6096
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Rheumatoid arthritis(RA) a chronic systemic connective tissue disease, one of the main symptoms is inflammation that is mainly present in hands and feet. The evaluation and follow-up of disease activity relies on composite indexes with clinical outcomes. However, many studies have shown there are differences between disease activity measured by clinical examination and ultrasound findings(1). Objectives: The aim of this study was to evaluate the utility of ultrasound in patients with RA stratified as moderate or severe disease activity based on DAS28. Methods: We performed across-sectional study including patients with RA; patients were followed-upunder T2T standards and a multidisciplinary approach. Clinical follow-up was designed by the authors according to DAS28 as follows: every 3-5 weeks (DAS28 >5.1), every 7-9 weeks (DAS28 ≥3.1 and ≤5.1), and every 11-13 weeks (DAS28 <3.1). Additionally the patient was evaluated by a rheumatologist expert in ultrasound; US studies were carried out with a Esaote MyLab Seven® US equipment (Biomedica, Genoa, Italy) equipped with a 10-18 MHz linear transducer; PD was adjusted according to the following parameters: frequency, 8.0, PRF, 0.500, wall filter 3, gain between 50 and 70. The rheumatologist reported erosions, synovitis, osteophytesand power Doppler; we defined as active disease when patients had synovitis orpositive power Doppler. We calculated means, and standard deviations for continuous variables and categorical variables were presented as rates. We performed a bivariate analysis using Pearson's Chi 2 Results: 272 patients meet the inclusion criteria; most of patients were woman 87%, mean age were 57 years±11, mean DAS was 4.45±1.1, 70% of patients were in moderate disease activity (MDA), and 30% in severe disease activity (SDA), 81% of patients were receiving conventional DMARDs therapy and 19% biological therapy. Regarding the findings of the ultrasound, the most prevalent elementary lesions in hands and feet were erosions, 75% and 6% see table 1. Active disease was found in 66% (11% of patients had only synovitis and 55% had synovitis plus Doppler) see table 2. Thus, in patients where we assumed that had MDA or SDA, by ultrasound we found that 34% did not have disease activity. We did not find statistical association between ultrasound and age, sex or type of pharmacological therapy. Conclusions: In RA patients with moderate or severe disease activity ultrasonography can complement the clinical evaluation, since there are a third of patients without disease activity according to ultrasound findings; where by there is a need for further research in order to identify the reasons of non-active disease activity in patients classified clinically as in moderate or severe disease activity. Reference: [1] Jeka S, Dura M, Zuchowski P, Zwierko B, Wojciechowski R. The role ofultrasonography in monitoring long-standing rheumatoid arthritis: a pilotstudy. Reumatologia 2017;55(4):177-82. Disclosure of Interest: None declared