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.
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 November 27, 2020.
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