論文

査読有り
2015年7月

Predictive value of bone destruction and duration of clinical remission for subclinical synovitis in rheumatoid arthritis patients

MODERN RHEUMATOLOGY
  • Nao Tokai
  • ,
  • Michihiro Ogasawara
  • ,
  • Misa Gorai
  • ,
  • Yuko Matsuki
  • ,
  • Yusuke Yamada
  • ,
  • Go Murayama
  • ,
  • Nagachika Sugisaki
  • ,
  • Takuya Nemoto
  • ,
  • Seiichiro Ando
  • ,
  • Kentaro Minowa
  • ,
  • Takayuki Kon
  • ,
  • Kurisu Tada
  • ,
  • Masakazu Matsushita
  • ,
  • Ken Yamaji
  • ,
  • Naoto Tamura
  • ,
  • Shigeki Makino
  • ,
  • Yoshinari Takasaki

25
4
開始ページ
540
終了ページ
545
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.3109/14397595.2014.987421
出版者・発行元
SPRINGER

Objectives. Treatment for rheumatoid arthritis (RA) should aim to achieve full remission. The aim of this study was to investigate predictors of persistent subclinical synovitis and whether longer clinical remission is effective in reducing subclinical synovitis.
Methods. Forty-four RA patients who achieved DAS28ESR clinical remission for at least 3 months were enrolled in this study and underwent ultrasound examination of 22 joints (bilateral proximal interphalangeal joints, metacarpophalangeal joints, and wrists); bilateral hand X-ray; and blood examination. The severity of synovial effusion, synovial hypertrophy, and blood flow were semi-quantitatively graded from 0 to 3 using gray-scale (GS) and power Doppler (PD) modes.
Results. Among patients with DAS28ESR-defined clinical remission, 59.1% (26/44) demonstrated residual synovitis (>= PD1) in at least one joint. Genant-modified total Sharp score (TSS) demonstrated the highest statistical difference between patients with and without residual subclinical synovitis (p = 0.0057), and full remission was only observed in patients with low TSS. A nonsignificant trend for decreased residual synovitis with longer sustained clinical remission was also observed (p = 0.724).
Conclusion. Residual synovitis can persist during clinical remission, particularly in patients with progressive bone destruction. Early treatment and longer sustained clinical remission prior to bone destruction are critical for full remission.

Web of Science ® 被引用回数 : 8

リンク情報
DOI
https://doi.org/10.3109/14397595.2014.987421
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/25496404
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000358935600007&DestApp=WOS_CPL

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