title: Ultrasonography predicts achievement of Boolean remission after DAS28-based clinical remission of rheumatoid arthritis.
abstract: OBJECTIVE
  To determine whether ultrasonography (US) predicts Boolean remission in rheumatoid arthritis (RA) patients who had achieved disease activity score in 28 joints (DAS28)-based remission criteria.
  
  
  METHODS
  Thirty-one RA patients in DAS28-based clinical remission were recruited. US semiquantitatively determined Gray scale (GS) and power Doppler (PD) signal scores in the bilateral wrists and all metacarpophalangeals and proximal interphalangeals. Total GS score and total PD score were calculated as the sum of individual scores for each joint.
  
  
  RESULTS
  Among 22 RA patients, who maintained DAS28 remission for 2 years, 16 met Boolean remission criteria at the end of study. Both total GS and total PD scores at baseline were significantly lower in Boolean remission group than non-remission group. There was no significant difference in other baseline parameters, including duration of disease, duration of remission, mTSS, and disease activity composite parameters between the two groups. Among the factors for Boolean remission criteria at 2 years, patient global assessment score was associated with total GS score at the entry, while swollen joint count was related to total PD score.
  
  
  CONCLUSIONS
  Null or low grade of GS and PD findings in US are associated with achieving Boolean remission. Thus, US is essential for assessment and prediction of "deeper remission" of RA.
authors.affiliation: Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine , Yokohama , Japan.
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Yoshimi
authors.forename: Maasa
authors.initials: M
authors.lastname: Hama
authors.forename: Kaoru
authors.initials: K
authors.lastname: Minegishi
authors.forename: Daiga
authors.initials: D
authors.lastname: Kishimoto
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Watanabe
authors.forename: Reikou
authors.initials: R
authors.lastname: Kamiyama
authors.forename: Yohei
authors.initials: Y
authors.lastname: Kirino
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Asami
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ihata
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Tsunoda
authors.forename: Atsuhisa
authors.initials: A
authors.lastname: Ueda
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Takeno
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Ishigatsubo
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000188:drug therapy; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008662:Metacarpophalangeal Joint / Q000000981:diagnostic imaging*; D008875:Middle Aged; D012074:Remission Induction; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014463:Ultrasonography; D014955:Wrist Joint / Q000000981:diagnostic imaging*
chemical_list: D018501:Antirheumatic Agents
keywords: Boolean remission; Clinical remission; Power Doppler; Rheumatoid arthritis; Ultrasonography