ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • Register
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 0313

Swollen Joints but Not Tender Joints Are Associated with Ultrasound Power Doppler Synovitis in Very Early DMARD Naive Psoriatic Arthritis

Sayam Dubash1, Oras Alabas1, Xabier Michelena1, Leticia Garcia-Montoya1, Gabriele De Marco2, Mira Merashli3, Richard Wakefield1, Philip Helliwell4, Ai Lyn Tan1, Dennis McGonagle1, Paul Emery5 and Helena Marzo-Ortega1, 1The University of Leeds, Leeds Institute for Rheumatic and Musculoskeletal Medicine, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds, UK, Leeds, United Kingdom, 2The University of Leeds, Leeds Institute for Rheumatic and Musculoskeletal Medicine, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds, UK, Treviglio, Italy, 3The University of Leeds, Leeds Institute for Rheumatic and Musculoskeletal Medicine, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds, UK, Beirut, Lebanon, 4Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom, 5Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK, Leeds, United Kingdom

Meeting: ACR Convergence 2020

Keywords: Disease Activity, Outcome measures, Psoriatic arthritis, Synovitis, Ultrasound

  • Tweet
  • Email
  • Print
Save to PDF
Session Information

Date: Friday, November 6, 2020

Session Title: Spondyloarthritis Including Psoriatic Arthritis – Diagnosis, Manifestations, & Outcomes Poster I: Psoriatic Arthritis

Session Type: Poster Session A

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

Background/Purpose: Clinical tender and swollen joint counts are used for biologic drug eligibility and clinical trial inclusion criteria. Ultrasonography (US)  adds to clinical examination as it is a sensitive imaging modality in the assessment of inflammatory arthritis, yet its relationship with tender and swollen joints is not fully understood. The objective of this study was to explore the relationship between clinical examination and US determined synovitis in very early, DMARD naïve psoriatic arthritis (PsA).  

Methods: Eligible PsA patients determined by CASPAR criteria underwent matched clinical and US joint assessments (44 joints). Disease activity per joint was determined by tender/swollen joints (TJ/SJ) and US synovitis defined by power Doppler (PD) ≥1. Agreement between TJ/SJ and PD≥1 was conducted at the individual joint level and patient level (TJC/SJC). Statistical agreement between clinical and US assessments was calculated using prevalence-adjusted and bias-adjusted kappa (PABAK), and the association was determined using the Spearman’s rank test (rho/ρ).

Results: A total of 5,616 joints were assessed using US in 155 patients [median disease duration (interquartile range (IQR)) 1.1 months (0-3.0) from diagnosis; median symptom duration (IQR) 12 months (7-30)]. Grayscale (GS) was identified in 2273/5616 (40.4%) and PD≥1 in 292/5616 (5.2%) joints. Agreement between SJ and PD was very high at the individual joint level (82.6 – 96.3%, PABAK 0.65- 0.93) and patient level (SJ and PD≥1: 89.9%, PABAK 0.80), as per figure 1. Joints that were tender and swollen (T+ S+) demonstrated weak/moderate correlation (r=0.28, p< 0.001) with PD≥1 synovitis at the patient and individual levels. However, tender joints in the absence of swelling (T+ S-) did not correlate with PD synovitis (r=0.01) at the patient level, with negligible correlation at individual joint level (table 1).

Conclusion: In very early, DMARD naïve PsA, clinically swollen joints are associated with PD synovitis, but tender, non-swollen joints are not. Further understanding of the aetio-pathology of joint tenderness may disentangle its complex relationship in early PsA.

Figure 1: Percentage agreement (%) and adjusted kappa (PABAK) with 95% CIs between tender/swollen joints and ultrasound power Doppler Synovitis per joint.

Table 1: Individual joint level correlation (rho) between tender non-swollen joints versus tender and swollen joints. Lack of correlation was determined by the absence of swelling.


Disclosure: S. Dubash, None; O. Alabas, None; X. Michelena, None; L. Garcia-Montoya, None; G. De Marco, None; M. Merashli, None; R. Wakefield, Novartis, 8, Janssen, 8, GE, 8; P. Helliwell, AbbVie, 2, 8, Janssen, 2, Pfizer Inc, 8, Celgene, 8, Galapagos, 8, Amgen, 8, Novartis, 2, UCB, 8; A. Tan, None; D. McGonagle, AbbVie Inc., 2, 8, Janssen Research & Development, LLC, 2; P. Emery, AbbVie, 2, 8, Bristol-Myers Squibb Company, 2, 8, Pfizer, 8, Roche, 2, 8, Celltrion, 8, Eli Lilly, 8, Gilead, 8, Novartis, 2, 8, Samsung, 8; H. Marzo-Ortega, Novartis, 2, 5, 8, Janssen, 2, 5, 8, Eli Lilly, 5, 8, Pfizer, 5, 8, UCB, 5, 8, AbbVie Inc., 5, 8, Celgene, 5, 8, Takeda Pharmaceutical Company, 5, 8.

To cite this abstract in AMA style:

Dubash S, Alabas O, Michelena X, Garcia-Montoya L, De Marco G, Merashli M, Wakefield R, Helliwell P, Tan A, McGonagle D, Emery P, Marzo-Ortega H. Swollen Joints but Not Tender Joints Are Associated with Ultrasound Power Doppler Synovitis in Very Early DMARD Naive Psoriatic Arthritis [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/swollen-joints-but-not-tender-joints-are-associated-with-ultrasound-power-doppler-synovitis-in-very-early-dmard-naive-psoriatic-arthritis/. Accessed January 21, 2021.
  • Tweet
  • Email
  • Print
Save to PDF

« Back to ACR Convergence 2020

ACR Meeting Abstracts - https://acrabstracts.org/abstract/swollen-joints-but-not-tender-joints-are-associated-with-ultrasound-power-doppler-synovitis-in-very-early-dmard-naive-psoriatic-arthritis/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Convergence: Where Rheumatology Meets. All Virtual. November 5-9.

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2021 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.