title: Clinical and ultrasonographic remission determines different chances of relapse in early and long standing rheumatoid arthritis.
abstract: OBJECTIVE
  Treatment of rheumatoid arthritis (RA) should aim at full remission. The aims of this study were to define: (1) how many patients reached ultrasound power Doppler (US-PD) remission in a cohort of patients with early RA (ERA) compared with longstanding RA (LSRA); (2) possible predictors of US-PD remission; and (3) how many patients with and without US-PD remission relapsed after 1 year of follow-up in ERA and LSRA.
  
  
  METHODS
  48 patients with ERA and 46 with LSRA with disease activity score <1.6 underwent US assessment. Six hand and wrist joints were studied for active synovitis. 56.2% of patients with ERA and 50.0% of those with LSRA fulfilled American College of Rheumatology (ACR) remission criteria.
  
  
  RESULTS
  43.7% of patients with ERA and 17.4% of those with LSRA had no evidence of synovitis at US evaluation. Using a stricter clinical definition of remission (ie, ACR criteria), US evaluation confirmed clinical remission in 66.7% of patients with ERA and 26.1% of those with LSRA. Early disease was predictive of clinical US remission. 20.0% of patients with RA who had a negative PD signal at the US evaluation had a flare during the 12-month follow-up period compared with 47.1% of patients who had a positive PD signal.
  
  
  CONCLUSIONS
  US-PD remission occurs in half of patients with ERA and in a minority of patients with LSRA in clinical remission. Early disease seems to be the major determinant of full remission.
authors.affiliation: Division of Rheumatology, UCSC-Catholic University of Rome, Complesso Integrato Columbus-CIC, Rome, Italy.
authors.forename: Giusy
authors.initials: G
authors.lastname: Peluso
authors.forename: Alessandro
authors.initials: A
authors.lastname: Michelutti
authors.forename: Silvia
authors.initials: S
authors.lastname: Bosello
authors.forename: Elisa
authors.initials: E
authors.lastname: Gremese
authors.forename: Barbara
authors.initials: B
authors.lastname: Tolusso
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Ferraccioli
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D004812:Epidemiologic Methods; D005260:Female; D050823:Hand Joints / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012074:Remission Induction; D013585:Synovitis / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D014955:Wrist Joint / Q000000981:diagnostic imaging
chemical_list: D018501:Antirheumatic Agents