ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 137

Imaging Remission By Musculoskeletal Ultrasound Leads to a Better Functional Outcome – Results of the US Impera Study – US 7-Score Implementation Study in Early Rheumatoid Arthritis

Anne-Marie Glimm1, Sarah Ohrndorf2, Imma Fischer3, Johannes Strunk4, Wolfgang A. Schmidt5, Wolfgang Hartung6, Herbert Kellner7, Horst Sattler8, Gabriela Schmittat1, GR Burmester9 and Marina Backhaus10, 1Department of Rheumatology and Clinical Immunology, Charité University Medicine Berlin, Berlin, Germany, 2Rheumatology and Clinical Immunology, Charité-University Medicine Berlin, Berlin, Germany, 3Biostatistik Tuebingen, Tuebingen, Germany, 4Department of Rheumatology, Hospital 'Porz am Rhein', Academic Hospital of the University of Cologne, Cologne, Germany, 5Medical Center for Rheumatology and Clinical Immunology Berlin-Buch, Immanuel Krankenhaus Berlin, Berlin, Germany, 6Department of Rheumatology and Clinical Immunology, Asklepios Klinik Bad Abbach, Bad Abbach, Germany, 7Department of Internal Medicine – Rheumatologic Day Clinic, Krankenhaus Neuwittelsbach, Academic Hospital of Ludwig-Maximilians-University Munich, Munich, Germany, 8Internal Medicine and Rheumatology Practice, Bad Duerkheim, Bad Duerkheim, Germany, 9Charité – University Medicine Berlin, Berlin, Germany, 10Department of Rheumatology & Immunology, University Medicine Charit, Berlin, Germany

Meeting: ACR/ARHP Annual Meeting 2016

Date of first publication: September 28, 2016

Keywords: , ,

Session Information

Date: Sunday, November 13, 2016

Title: Imaging of Rheumatic Diseases - Poster I: Ultrasound and Emerging Technologies

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Novel treat-to-target strategies present new challenges to treatment monitoring in rheumatoid arthritis (RA). To compare functional outcomes in early RA patients monitored by standard of care alone (clinical cohort) or with an additional musculoskeletal ultrasound examination (US cohort) following a treat-to-target strategy in a nationwide investigator-initiated study in Germany.

Methods: Functional, clinical and laboratory parameters monitored over 18 months in both cohorts were: Health Assessment Questionnaire (HAQ), Disease Activity Score 28 (DAS28), Visual Analogue Scale (VAS), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Ultrasound remission criteria used in the US cohort were: gray-scale ultrasound (GSUS) <2 at joint level and power Doppler ultrasound (PDUS) = 0. We additionally compared HAQ, DAS28, VAS, ESR and CRP in US cohort subgroups with and without ultrasound remission.

Results: In all 313 patients (US cohort: n=166, clinical cohort: n=147), laboratory activity, DAS28, VAS and HAQ decreased to low-disease activity levels within 18 months after the beginning or change of antirheumatic therapy, with no significant differences between groups. However, US cohort members with ultrasound remission (n=79) had significantly lower HAQ (0.401 vs. 0.741, p=0.002), DAS28 (2.2 vs. 3.4, p<0.001) and VAS disease activity scores (16.6 mm vs. 33.9 mm, p<0.001) than those without ultrasound remission (n=87).

Conclusion: Treat-to-target strategies reduced disease activity and improved functional outcomes (HAQ) in our early RA patients, irrespective of the monitoring regimen. However, patients with ultrasound remission had significantly better disease activity scores and functional outcomes. Accordingly, ultrasound should be strongly considered as an additional monitoring tool in clinical practice. 

Disclosure: A. M. Glimm, None; S. Ohrndorf, None; I. Fischer, None; J. Strunk, None; W. A. Schmidt, Abbvie, 5,Berlin Chemie, 5,GlaxoSmithKline, 5,Lilly, 5,Novartis Pharmaceutical Corporation, 5,Roche Pharmaceuticals, 5,Abbvie, 8,Berlin Chemie, 8,Medac, 8,Merck Pharmaceuticals, 8,Novartis Pharmaceutical Corporation, 8,Pfizer Inc, 8,Roche Pharmaceuticals, 8,UCB, 8,Abbvie, 2,GlaxoSmithKline, 2,Novartis Pharmaceutical Corporation, 2,Roche Pharmaceuticals, 2; W. Hartung, None; H. Kellner, None; H. Sattler, None; G. Schmittat, None; G. Burmester, UCB, 2,AbbVie, 5,BMS, 5,Hexal, 5,Janssen Pharmaceutica Product, L.P., 5,Lilly, 5,MSD, 5,MadImmune, 5,Novartis Pharmaceutical Corporation, 5,Pfizer Inc, 5,Roche Pharmaceuticals, 5,AbbVie, 8,BMS, 8,Hexal, 8,MSD, 8,Novartis Pharmaceutical Corporation, 8,Pfizer Inc, 8,Roche Pharmaceuticals, 8; M. Backhaus, None.

To cite this abstract in AMA style:

Glimm AM, Ohrndorf S, Fischer I, Strunk J, Schmidt WA, Hartung W, Kellner H, Sattler H, Schmittat G, Burmester G, Backhaus M. Imaging Remission By Musculoskeletal Ultrasound Leads to a Better Functional Outcome – Results of the US Impera Study – US 7-Score Implementation Study in Early Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/imaging-remission-by-musculoskeletal-ultrasound-leads-to-a-better-functional-outcome-results-of-the-us-impera-study-us-7-score-implementation-study-in-early-rheumatoid-arthritis/. Accessed .

« Back to ACR/ARHP Annual Meeting 2016

ACR Meeting Abstracts - https://acrabstracts.org/abstract/imaging-remission-by-musculoskeletal-ultrasound-leads-to-a-better-functional-outcome-results-of-the-us-impera-study-us-7-score-implementation-study-in-early-rheumatoid-arthritis/