Session Information
Date: Saturday, November 7, 2020
Title: RA – Diagnosis, Manifestations, & Outcomes Poster II: Biomarkers
Session Type: Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Ultrasound (US) imaging biomarkers in the context of Anti-Citrullinated Protein Antibody (ACPA) autoimmunity might play an important role in the very early detection of Rheumatoid Arthritis (RA).
Methods: Individuals with musculoskeletal complaints suspicious for rheumatic disease, and having a positive anti-CCP2 test were referred to the Rheumatology Unit. Sixty eight joint counts as well as hands, feet and any symptomatic joints by US examination were performed. US were scored for synovial hypertrophy (SH) and Doppler activity according to EULAR-OMERACT definitions. Individuals not having arthritis defined by clinical examination and ultrasound were included in the RISK RA prospective cohort. Finger and wrist tendons were examined for any signs of tenosynovitis, including evaluations between joints for bursitis. The associations of US biomarkers with arthritis development was tested (comparing proportions) using Chi-Squared or Fisher’s exact tests.
Results: 288 individuals were included in the RISK RA study from year 2014 to October 2019 (79% female, 35% RF positive, median age 48 yrs: IQR: 36-58). Within a median of 38 months (IQR: 1-72) since recruitment, 28% (84/288) progressed to arthritis.
At any scan done prior to diagnosis (either inclusion or follow-up visits), two thirds (193/288) of all individuals lacked any signs of US changes with only 16% (31/193) of them developing arthritis. One third (95/288) of all individuals had at least one type of US change (tenosynovitis, synovial hypertrophy without Doppler and/or bursitis) and 56% (53/95) of them developed arthritis. A majority, 64% (61/95), of individuals with any US changes had only one type of US change.
Tenosynovitis was detected in 22% (64/288) of all individuals, more frequently in those developing arthritis (44%, 37/84) as compared to those not developing arthritis (13%, 27/204), p< 0.0001. The extensor-carpi-ulnaris wrist tendons were mostly affected. Synovial hypertrophy (grade 1 or 2) was detected in 11% (32/288) of all individuals, more frequently noted among those developing (21%,18/84) as compared to those not developing arthritis (7%,14/204), p< 0.0001. The MCP joints were mostly affected. Bursitis between MTP joints were detected in 9% (25/288) of all individuals, more frequently among those developing (13%, 11/84) as compared to those not developing arthritis (7%, 14/204), p=0.09.
Conclusion: Tenosynovitis, synovial hypertrophy and bursitis are useful ultrasound biomarkers for predicting arthritis development in a population at-risk for RA.
To cite this abstract in AMA style:
Kisten Y, Circiumaru A, Loberg-Haarhaus M, Vivar N, Antovic A, Rezaei H, Af Klint E, Hensvold A, Catrina A. Presence of Ultrasound Imaging Biomarkers Are Good Predictors of Arthritis Development in a Population at Risk for Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/presence-of-ultrasound-imaging-biomarkers-are-good-predictors-of-arthritis-development-in-a-population-at-risk-for-rheumatoid-arthritis/. Accessed .« Back to ACR Convergence 2020
ACR Meeting Abstracts - https://acrabstracts.org/abstract/presence-of-ultrasound-imaging-biomarkers-are-good-predictors-of-arthritis-development-in-a-population-at-risk-for-rheumatoid-arthritis/