Investigation of remission with ultrasound in patients with rheumatoid arthritis according to different clinical remission criteria

Abstract

Objectives: To investigate remission with ultrasound (US) in patients with Rheumatoid arthritis (RA) according to different clinical remission criteria. Methods: A total of 105 patients with RA who were in remission for at least 6 months according to disease activity score in the 28 joints using C-reactive protein (DAS28-CRP) were included in the study. US remission rates were analyzed according to different remission criteria [DAS28-CRP, DAS28 using erythrocyte sedimentation rate (DAS28-ESR), clinical disease activity index (CDAI), simplified DAI (SDAI), and the 2011 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) Boolean remission criteria]. US remission was determined as power doppler (PD) US score = 0. Results: Remission rates achieved for each remission criteria were 100%, 82.9%, 55.2%, 58.1% and 42.9% and US remission rates were 57.1%, 57.5%, 53.4%, 55.7%, 57.7% for DAS28 CRP, DAS 28 ESR, CDAI, SDAI, 2011 ACR/EULAR remission criteria, respectively. When the patients compared for the US findings between remission and non-remission patients according to the different clinical remission criteria, no difference was found (p > 0.05). Conclusions: This study shows that clinical remission criterias are not sensitive enough to accurately detect remission and there was no increase in the US remission rates as per the stricter remission criteria. Using US in addition to the clinical criteria would prove to be more useful in evaluating remission.