Exploring a new ultrasound score as a clinical predictive tool in patients with rheumatoid arthritis starting abatacept: results from the APPRAISE study

Abstract

ObjectivesTo explore whether changes in a composite (power Doppler/greyscale ultrasound (PDUS)) synovitis score, developed by the OMERACT-EULAR-Ultrasound Task Force, predict disease activity outcomes in rheumatoid arthritis (RA).MethodsPatients with RA who were methotrexate inadequate responders starting abatacept were evaluated. Individual joint PDUS scores were combined in the Global OMERACT-EULAR Synovitis Score (GLOESS) for metacarpophalangeal joints (MCPs) 2–5, all joints (22 paired) and a reduced (9 paired) joint set. The predictive value of changes in GLOESS at week 1–16 evaluations for clinical status and response (Disease Activity Score (DAS)28 (C reactive protein, CRP) <2.6; DAS28(CRP) ≤3.2; DAS28(CRP) ≥1.2 improvement) up to week 24, and correlations between DAS28 and GLOESS were assessed.ResultsEighty-nine patients completed the 24-week treatment period. Changes in GLOESS (MCPs 2–5) from weeks 1 to 16 were unable to predict DAS28 outcomes up to week 24. However, significant improvements in GLOESS (MCPs 2–5) were observed at week 12 in patients with DAS28 ≥1.2 improvement at week 24 versus those who did not achieve that clinical response. In patients achieving DAS28 ≥1.2 improvement or DAS28 ≤3.2 at week 24, changes in GLOESS (22 and 9 paired joint sets) were greater in patients who already achieved DAS28 ≥1.2 at week 12 than in those who did not. No significant correlations were found between changes in DAS28 and GLOESS definitions at any time point.ConclusionsPDUS was not correlated with clinical status or response as measured by DAS28-derived criteria, and PDUS changes were not predictive of clinical outcome. The discrepancies require further exploration.Trial registration numberNCT00767325; Results.

Pain Catastrophizing, Subjective Outcomes, and Inflammatory Assessments Including Ultrasound: Results From a Longitudinal Study of Rheumatoid Arthritis Patients

“…This level of correlation may be caused by the high weight of patients’ evaluations in the different composite scores, since there was no or only minor correlation between US and the PROs. The present finding of only moderate associations between the US and composite scores is supported by several other studies .…”

Combination of ultrasound power Doppler‐verified synovitis and seropositivity accurately identifies patients with early‐stage rheumatoid arthritis

“…The EULAR‐OMERACT attempted to establish a single US scoring system based on the combined PD and GS (cPD score), especially for multicenter clinical trials . For the first time, the present study verified the cPD score for the application of the early diagnosis of RA.…”

“…We also assessed the novel Outcome Measures in Rheumatology (OMERACT)‐EULAR combined power Doppler ultrasound score (ie the cPD score) and the Global OMERACT‐EULAR Synovitis Score (GLOESS)0.1 The cPD score was combined with synovial hypertrophy shown by GS and PD . The GLOESS was calculated from the sum of cPD scores for the bilateral 2nd‐5th MCP joints …”

Serial magnetic resonance imaging and ultrasound examinations demonstrate differential inflammatory lesion patterns in soft tissue and bone upon patient-reported flares in rheumatoid arthritis

“…One combined GS and Doppler OMERACT-EULAR score was generated for synovitis and tenosynovitis [23,24]. The scores from single joints/regions were added into a Global OMERACT-EULAR Synovitis Score (GLOESS) [26]. For the wrist, one single score was used, corresponding to the maximum combined score from any of the joints evaluated at this region.…”