Utility of the HandScan in monitoring disease activity and prediction of clinical response in rheumatoid arthritis patients: an explorative study

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

doi:10.1093/rap/rkab004

Cited by 5 publications

(2 citation statements)

References 19 publications

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“…DAS-OST showed a moderate performance (AU-ROC 0.78), but statistically signi cantly less, compared to DAS28. The performance of OST-score alone was poor, in line with earlier published data, (11) indicating that the OST-score has to be combined with other parameters into an index. However, in this setting, in which the study population had been treated according to the treat-to-target principle, resulting in relatively low disease activity (median SJC 0 and mean DAS28 2.5), also the contribution of the OST-score to DAS-OST was negligible.…”

Section: Discussionsupporting

confidence: 84%

Classification of RA Into Active or Inactive With a Modified DAS, for Future Use as a Treat-to-target Tool, With a HandScan Score Replacing Joint Counts

Verhoeven

Westgeest

Tekstra

et al. 2021

Preprint

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ObjectivesTo establish the value of a modified DAS (DAS-OST) without joint counts but with a HandScan score (OST), versus that of DAS28, to classify RA as active versus inactive, with as reference standard the rheumatologist's clinical classification.MethodsRA patients with at least one HandScan and DAS28 measurement performed at the same visit were included. Data was extracted from medical records, as was the clinical interpretation as active or inactive RA by the rheumatologist. Logistic regression analyses were performed to calculate areas under the receiver operating characteristics (AU-ROC) curves. The clinical interpretation was used as reference standard in all analyses, and disease activity measures were used as predictor variables. The performance of predictor variables (AU-ROCs) was compared.ResultsData of 1505 unique RA patients were used for analyses. The highest AU-ROC of 0.88 (95%CI 0.85 – 0.90) was shown for DAS28; AU-ROC of DAS-OST was 0.78 (95%CI 0.75 – 0.81), difference 0.10, p<0.01.ConclusionsCompared to DAS28, DAS-OST classified RA statistically significantly less well as active versus inactive, when using the clinical classification as reference standard. However, a DAS-modification without joint scores might have a place in strategies limiting routine outpatients’ visits to the rheumatologist.

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Section: Discussionsupporting

confidence: 84%

Classification of RA Into Active or Inactive With a Modified DAS, for Future Use as a Treat-to-target Tool, With a HandScan Score Replacing Joint Counts

Verhoeven

Westgeest

Tekstra

et al. 2021

Preprint

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“…However, longitudinal data regarding the ability of OST to follow up the joint inflammatory changes in patients under anti-inflammatory therapy are scarce. Until now, there has been only one study published on the topic, which however examined correlations of OST with solely clinical parameters (DAS28), during a time period of 6 months [ 39 ]. In this study, a longitudinal association of OST scores with DAS28 could be found.…”

Section: Discussionmentioning

confidence: 99%

Optical spectral transmission to assess glucocorticoid therapy response in patients with arthritis: a longitudinal follow-up comparison with joint ultrasound

Triantafyllias

Marinoska²,

Heller

et al. 2023

Arthritis Res Ther

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Background Optical spectral transmission (OST) is a modern diagnostic modality, able to assess the blood-specific absorption of light transmitted through a tissue, promising quantification of inflammation in the finger and wrist joints of patients with arthritis. To date, there are no adequate data regarding the diagnostic value of OST in the evaluation of inflammatory activity changes, during arthritis follow-up. Objectives of this study were therefore to examine the performance of OST in assessing response to anti-inflammatory therapy in patients with active arthritis and to explore OST associations with clinical, laboratory, and ultrasonographic (US) activity markers. Methods 1173 joints of 54 patients with arthritides of the wrist and finger joints were examined by OST before and after oral administration of glucocorticoids (GC), during a disease flare. For the same time-points patients underwent clinical, laboratory, and joint US [grayscale (GSUS), power-Doppler (PDUS)] examinations. The distribution of ΔOST-values between the two time-points was compared with the respective distributions of ΔPDUS and ΔGSUS by Bayesian statistical analyses. Moreover, the diagnostic performance of OST compared to a control group (2508 joints of 114 subjects) was examined by receiver operating characteristics and associations of OST values with clinical, laboratory, and arthrosonographic parameters were evaluated by correlation analyses. Results OST and US performed similarly in the assessment of inflammatory changes caused by GC (same value-change tendency in 83.2% of the cases). Bayesian statistics revealed no significant differences between ΔOST and ΔPDUS for all 3 examined joint categories (accuracy: metacarpophalangeal (MCP): 68.1%; proximal interphalangeal (PIP): 60.4%; wrists: 50.4%) and between ΔOST and ΔGSUS for MCP and PIP joints (accuracy: 51.1% and 78.7%, respectively). OST diagnostic performance (patients vs. controls) was excellent in both time-points [area under the curve (AUC) before GC=0.883(95%CI=0.83–0.94) and after GC=0.811(95%CI=0.74–0.881); p<0.001]. Furthermore, OST correlated significantly with all examined sonographic activity scores (all; p<0.001) and with swollen joint counts (p<0.01). Conclusions OST was able to assess response to therapy in a similar way to joint US and correlated significantly with arthritis activity markers. Therefore, OST has proved to be a valuable tool to assist disease activity monitoring in the examined cohort. Trial registration German Registry of Clinical Trials, DRKS00016752

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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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Utility of the HandScan in monitoring disease activity and prediction of clinical response in rheumatoid arthritis patients: an explorative study

Cited by 5 publications

References 19 publications

Classification of RA Into Active or Inactive With a Modified DAS, for Future Use as a Treat-to-target Tool, With a HandScan Score Replacing Joint Counts

Classification of RA Into Active or Inactive With a Modified DAS, for Future Use as a Treat-to-target Tool, With a HandScan Score Replacing Joint Counts

Optical spectral transmission to assess glucocorticoid therapy response in patients with arthritis: a longitudinal follow-up comparison with joint ultrasound

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

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