Classification of rheumatoid arthritis into active or inactive with a modified Disease Activity score, for future use as a treat-to-target tool, with a HandScan score replacing joint counts

Verhoeven, Maxime M A; Westgeest, Anton; Tekstra, Janneke; Laar, Jacob M van; Lafeber, Floris P. J. G.; Welsing, Paco M J; Jacobs, Johannes W G

doi:10.55563/clinexprheumatol/tpsngs

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“…They concluded that the DAS-OST score seems to be the most accurate to monitor the patient’s disease activity, with good negative and positive predictive values for clinical remission. HandScan has also been described as effective to assess response to glucocorticoid therapy in patients with arthritis [ 9 ] and able to classify RA patients into active or inactive [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Optical imaging (HandScan) can identify ultrasound remission in rheumatoid arthritis

Rinkin,

Malaise,

Chauveheid

et al. 2024

BMC Musculoskelet Disord

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Background Identifying remission is of high importance in rheumatoid arthritis (RA) because remission is associated with less structural progression. We investigated the efficacy of a new optical imaging device, HandScan, to identify RA remission, as defined by ultrasound (US). Methods 61 RA patients were included. Disease activity was evaluated by clinical assessment and US, using gray-scale (GS) and Power Doppler (PD). HandScan determined unitary optical spectral transmission (OST) values for wrists, metacarpophalangeal and proximal interphalangeal joints. At the patient level, three composite HandScan (HS) scores were calculated: total HS score; disease activity score OST (DAS-OST) and DAS-OST without patient global assessment (PtGA). Using ROC curves, we determined HS cut-offs to identify US-defined remission. Results At the joint level, unitary OST values significantly correlated with GS synovitis [odds ratio (OR) 2.43, p < 0.0001] and PD positivity (OR 3.72, p = 0.0002 ). At the patient level, total HS score and DAS-OST were significantly associated with all gray-scale US (GSUS) and power doppler US (PDUS) parameters evaluated (synovitis number and grade, synovial thickness, PD grade) (p < 0.05). The cut-off to identify US-defined remission at the joint level was of 0.92, giving an 81% sensitivity and a 96% positive predictive value (PPV). At the patient level, ROC-curves failed to identify a robust cut-off for the total HS score, but did identify a cut-off (3.68) for DAS-OST to identify US-defined remission, but with lower sensitivity (75%), specificity (56%) and PPV (67%). Conclusions HandScan is a non-invasive optical imaging technique providing OST values that correlate with GSUS and PDUS parameters. In addition, HandScan is able to reliably identify US-defined remission in RA at the joint level, with a good sensitivity and high PPV. At the patient level, HandScan DAS-OST can also determine US remission (while total HS score failed to do so), but with lower performance.

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Section: Introductionmentioning

confidence: 99%