title: ACR/EULAR Definitions of Remission Are Associated with Lower Residual Inflammatory Activity Compared with DAS28 Remission on Hand MRI in Rheumatoid Arthritis.
abstract: To determine the level of residual inflammation [synovitis, bone marrow edema (BME), tenosynovitis, and total inflammation] quantified by hand magnetic resonance imaging (h-MRI) in patients with rheumatoid arthritis (RA) in remission according to 3 different definitions of clinical remission, and to compare these remission definitions.
  
  
  
  A cross-sectional study. To assess the level of residual MRI inflammation in remission, cutoff levels associated to remission and median scores of MRI residual inflammatory lesions were calculated. Data from an MRI register of patients with RA who have various levels of disease activity were used. These were used for the analyses: synovitis, BME according to the Rheumatoid Arthritis Magnetic Resonance Imaging Scoring system, tenosynovitis, total inflammation, and disease activity composite measures recorded at the time of MRI. Receiver-operating characteristic analysis was used to identify the best cutoffs associated with remission for each inflammatory lesion on h-MRI. Median values of each inflammatory lesion for each definition of remission were also calculated.
  
  
  
  A total of 388 h-MRI sets of patients with RA with different levels of disease activity, 130 in remission, were included. Cutoff values associated with remission according to the Simplified Disease Activity Index (SDAI) ≤ 3.3 and the Boolean American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) definitions for BME and tenosynovitis (1 and 3, respectively) were lower than BME and tenosynovitis (2 and 5, respectively) for the Disease Activity Score on 28 joints (DAS28) ≤ 2.6. Median scores for synovitis, BME, and total inflammation were also lower for the SDAI and Boolean ACR/EULAR remission criteria compared with DAS28.
  
  
  
  Patients with RA in remission according to the SDAI and Boolean ACR/EULAR definitions showed lower levels of MRI-detected residual inflammation compared with DAS28.
authors.affiliation: From the Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, Universidad Autónoma de Barcelona (UAB); Department of Radiology, Centro Radiologia Clínica (CRC), Hospital del Mar, Barcelona, Spain.M.P. Lisbona, MD, Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, UAB; A. Solano, MD, Department of Radiology, CRC, Hospital del Mar; J. Ares, MD, Department of Radiology, CRC, Hospital del Mar; M. Almirall, MD, Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, UAB; T.C. Salman-Monte, MD, Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, UAB; J. Maymó, MD, Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, UAB.
authors.forename: Maria Pilar
authors.initials: MP
authors.lastname: Lisbona
authors.affiliation: From the Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, Universidad Autónoma de Barcelona (UAB); Department of Radiology, Centro Radiologia Clínica (CRC), Hospital del Mar, Barcelona, Spain.M.P. Lisbona, MD, Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, UAB; A. Solano, MD, Department of Radiology, CRC, Hospital del Mar; J. Ares, MD, Department of Radiology, CRC, Hospital del Mar; M. Almirall, MD, Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, UAB; T.C. Salman-Monte, MD, Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, UAB; J. Maymó, MD, Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, UAB.
authors.forename: Albert
authors.initials: A
authors.lastname: Solano
authors.affiliation: From the Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, Universidad Autónoma de Barcelona (UAB); Department of Radiology, Centro Radiologia Clínica (CRC), Hospital del Mar, Barcelona, Spain.M.P. Lisbona, MD, Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, UAB; A. Solano, MD, Department of Radiology, CRC, Hospital del Mar; J. Ares, MD, Department of Radiology, CRC, Hospital del Mar; M. Almirall, MD, Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, UAB; T.C. Salman-Monte, MD, Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, UAB; J. Maymó, MD, Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, UAB.
authors.forename: Jesús
authors.initials: J
authors.lastname: Ares
authors.affiliation: From the Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, Universidad Autónoma de Barcelona (UAB); Department of Radiology, Centro Radiologia Clínica (CRC), Hospital del Mar, Barcelona, Spain.M.P. Lisbona, MD, Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, UAB; A. Solano, MD, Department of Radiology, CRC, Hospital del Mar; J. Ares, MD, Department of Radiology, CRC, Hospital del Mar; M. Almirall, MD, Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, UAB; T.C. Salman-Monte, MD, Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, UAB; J. Maymó, MD, Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, UAB.
authors.forename: Miriam
authors.initials: M
authors.lastname: Almirall
authors.affiliation: From the Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, Universidad Autónoma de Barcelona (UAB); Department of Radiology, Centro Radiologia Clínica (CRC), Hospital del Mar, Barcelona, Spain.M.P. Lisbona, MD, Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, UAB; A. Solano, MD, Department of Radiology, CRC, Hospital del Mar; J. Ares, MD, Department of Radiology, CRC, Hospital del Mar; M. Almirall, MD, Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, UAB; T.C. Salman-Monte, MD, Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, UAB; J. Maymó, MD, Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, UAB.
authors.forename: Tarek Carlos
authors.initials: TC
authors.lastname: Salman-Monte
authors.affiliation: From the Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, Universidad Autónoma de Barcelona (UAB); Department of Radiology, Centro Radiologia Clínica (CRC), Hospital del Mar, Barcelona, Spain.M.P. Lisbona, MD, Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, UAB; A. Solano, MD, Department of Radiology, CRC, Hospital del Mar; J. Ares, MD, Department of Radiology, CRC, Hospital del Mar; M. Almirall, MD, Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, UAB; T.C. Salman-Monte, MD, Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, UAB; J. Maymó, MD, Department of Rheumatology, Hospital del Mar, Parc de Salut Mar, UAB. jmaymo@parcdesalutmar.cat.
authors.forename: Joan
authors.initials: J
authors.lastname: Maymó
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000188:drug therapy; D003430:Cross-Sectional Studies; D018450:Disease Progression; D050823:Hand Joints / Q000000981:diagnostic imaging*; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D012074:Remission Induction; D012720:Severity of Illness Index; D013585:Synovitis / Q000000981:diagnostic imaging* / Q000188:drug therapy; D013717:Tenosynovitis / Q000000981:diagnostic imaging* / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents
keywords: MAGNETIC RESONANCE IMAGING; REMISSION; RHEUMATOID ARTHRITIS; RHEUMATOID ARTHRITIS MAGNETIC RESONANCE IMAGING SCORING