Date: Monday, October 22, 2018
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
In this study, we aimed to investigate the concordance of ultrasonographic remission with other remission criteria and to show the influence of non-inflammatory patient-induced factors such as depression, anxiety, fibromyalgia and fatigue on both clinical and ultrasonographic remission.
Fifty consecutive patients with clinical remission (DAS-28-ESR <2.6) who were diagnosed according to the 2010 ACR / EULAR criteria were recruited to this study.
Patients were also assessed whether they met the Boolean and SDAI remission criteria. 28 joint gray scale (GS) and power Doppler (PD) ultrasonography were performed. Patients’ depression and anxiety were assessed by The Hospital Anxiety and Depression Scale (HADS), and their fatigue was assessed by multidimensional Assessment of Fatigue (MAF) scores and patients’ fibromyalgia was assessed by widespread pain index (WPI) and symptom severity score (SS).
Patients were divided into 4 groups according to different remission definitions by ultrasonography. (Group1: PD=0 and GS=0, Group2: PD=0 and GS≥0, Group3: PD=1 or 0 and GS=1 or 0, Group4: PD=1 or 0 and GS≥0).
Although it is not statistically significant, the highest agreement with all the clinical remission criteria was found in the USG remission group 4 (table).
Patients with ultrasonographic remissions at their first visit in 2011 were reevaluated with clinical remission criteria at the end of 5 years. The highest remission rates were found in patients with USG remission group 3 (DAS28 58%, Boolean 29%, SDAI 47%). There was no significant difference between fatigue, fibromyalgia, depression and anxiety measures between remission and non-remission in all USG remission groups. In contrast, depression (p <0.05) and anxiety (p <0.03) were significantly higher in patients without SDAI remission. Depression (p <0.008) and anxiety (p <0.014) were also significantly higher in patients without Boolean remission.
Clinical and ultrasonographic remission was found to be compatible in half of the patients.
The compliance of the USG remission in Group 4 with the clinical remission definitions was good, and clinical remission continuity was higher in the group meeting the definition of group 3. In contrast the ultrasound remission, the high levels of depression and anxiety in patients without SDAI and Boolean remission suggest that non-inflammatory patient-derived measures have less influence on the ultrasound remission.
Table: The concordance between Ultrasound remission and other remission criteria
|Das28 (n=50)||SDAI (n=23)||Boolean (n=22)|
|Group 1: PD=0 GS=0||n ( %)||13 (% 26)||8(%34,7)||5 (%22,7)|
|Group 2: PD=0 GS≥0||n ( %)||22 ( % 44)||10 (%43,4)||8(%36,3)|
|Group 3: PD=1 or 0 and GS=1 or 0||n ( %)||17 (%34)||8 (%34,7)||7 (%31,8)|
|Group 4: PD=1 or 0 and GS≥0||n ( %)||28 (%56)||13(%56,5)||11 (%50)|
To cite this abstract in AMA style:Gazel U, Yilmaz Oner S, Ozen G, Yalçınkaya Y, Atagunduz P, Direskeneli H, Inanc N. Correlation between Clinical and Ultrasonographic Remission? the Effect of Non-Inflammatory Patient-Based Factors on Different Remission Definitions [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/correlation-between-clinical-and-ultrasonographic-remission-the-effect-of-non-inflammatory-patient-based-factors-on-different-remission-definitions/. Accessed February 28, 2020.
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