Standardisation of synovial biopsy analyses in rheumatic diseases: a consensus of the EULAR Synovitis and OMERACT Synovial Tissue Biopsy Groups

Abstract

BackgroundThe aim of this global collaboration was to develop a consensual set of items for the analysis of synovial biopsies in clinical practice and translational research through the EULAR Synovitis Study Group (ESSG) and OMERACT Synovial Tissue Biopsy Group.MethodsParticipants were consulted through a modified Delphi method. Three sequential rounds occurred over 12 months. Members were sent a written questionnaire containing items divided into two parts. Items were identified and formulated based on a scoping review. The first part of the questionnaire referred to synovial biopsies in clinical practice including five subsections, and the second part to translational research with six subsections. Every participant was asked to score each item on a 5-point Likert scale. Items with a median score above 3.5 and a ≥ 70% agreement were selected for the next round. The last round was conducted orally at EULAR in June 2017.ResultsTwenty-seven participants from 19 centers were contacted by email. Twenty participants from 17 centers answered. Response rates for next rounds were 100%. For the first part relating to clinical practice, 20/44 items (45.5%) were selected. For the second part relating to translational research, 18/43 items (41.9%) were selected for the final set.ConclusionsWe herein propose a consensual set of analysis items to be used for synovial biopsies conducted in clinical practice and translational research.Electronic supplementary materialThe online version of this article (10.1186/s13075-018-1762-1) contains supplementary material, which is available to authorized users.

Loss of α2-6 sialylation promotes the transformation of synovial fibroblasts into a pro-inflammatory phenotype in Rheumatoid Arthritis

“…In conclusion, in the present report, we revealed that the reduction of α2 For active naïve and remission RA patients 59 , biopsies were collected using a standard operating procedure with sampling of at least 6-8 different tissue pieces as required by the international recommendations for synovial tissue analysis 60,61 .…”

Synovial tissue biopsy analysis: unlocking the hidden secrets to personalised medicine?

“…Detailed analysis of synovial tissue biopsies (STB) is likely to reveal urgently needed, robust biomarkers that will guide clinical decisions, and stratify patients according to their disease subgroup and predicted response to treatment. With this in mind, Najm and colleagues have undertaken a consensus exercise to identify factors that are important for the reliability and reproducibility of STB analysis across centres [1].…”

“…However, the fourth—standardisation in the handling, evaluation and interpretation of STB—requires considerable effort from the international rheumatology community to reach consensus. Najm et al have now established a list of consensus points for standardised STB handling and analytical procedures in two situations—clinical practice and translational research [1]—and upon which a standardisation framework can be built. This task force used a modified Delphi analysis (structured anonymised questionnaire answered independently by a panel of experts) considering factors linked to biopsy sampling, processing, histological criteria, immunohistochemistry analysis, STB interpretation and pathologists report for both situation, and also RNA analysis for translational research [1].…”

“…Najm et al have now established a list of consensus points for standardised STB handling and analytical procedures in two situations—clinical practice and translational research [1]—and upon which a standardisation framework can be built. This task force used a modified Delphi analysis (structured anonymised questionnaire answered independently by a panel of experts) considering factors linked to biopsy sampling, processing, histological criteria, immunohistochemistry analysis, STB interpretation and pathologists report for both situation, and also RNA analysis for translational research [1]. For the full list of items Figure 2 in Najm et al, 2018 [1], but it is worth noting that the majority of items are identical for both clinical practice and translational research.…”

Correction to: Standardisation of synovial biopsy analyses in rheumatic diseases: a consensus of the EULAR Synovitis and OMERACT Synovial Tissue Biopsy Groups

“…Following publication of the original article [1], the authors reported an error in the spelling of the ninth author’s name.…”