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SAT0061 Concurrent Ultrasound-Detected Synovitis and Tenosynovitis Predict Flare in Patients with Rheumatoid Arthritis in Clinical Remission
  1. G. Sakellariou1,
  2. E. Bellis2,
  3. C.A. Scirè3,
  4. G. Carrara3,
  5. A. Adinolfi4,
  6. A. Bortoluzzi5,
  7. A. Batticciotto6,
  8. G. Cagnotto1,
  9. M. Caprioli7,
  10. M. Canzoni8,
  11. F.P. Cavatorta9,
  12. O. De Lucia10,
  13. V. Di Sabatino4,
  14. A. Draghessi11,
  15. G. Filippou4,
  16. I. Farina5,
  17. M.C. Focherini12,
  18. A. Gabba13,
  19. M. Gutierrez11,
  20. L. Idolazzi14,
  21. F. Luccioli15,
  22. P. Macchioni16,
  23. M.S. Massarotti17,
  24. C. Mastaglio18,
  25. L. Menza18,
  26. M. Muratore19,
  27. S. Parisi20,
  28. V. Picerno4,
  29. M. Piga13,
  30. R. Ramonda21,
  31. B. Raffeiner22,
  32. D. Rossi23,
  33. S. Rossi1,
  34. P. Rossini24,
  35. C. Scioscia25,
  36. C. Venditti26,
  37. A. Volpe9,
  38. M. Matucci-Cerinic27,
  39. A. Iagnocco28
  1. 1Pol. S. Matteo, Pavia
  2. 2Osp. Mauriziano, Torino
  3. 3Italian Soc. for Rheumatol., Milano
  4. 4Pol. le Scotte, Siena
  5. 5AOU S. Anna di Cona, Ferrara
  6. 6Osp. L. Sacco, Milano
  7. 7Ist. Clin. B.M. di Vigevano e Ist. Cura Città di Pavia, Pavia
  8. 8AO S. Andrea, Roma
  9. 9AOUP S. Chiara, Trento
  10. 10Gaetano Pini Inst, Milano
  11. 11U. Politecnica delle Marche, Jesi
  12. 12Osp. Infermi, Rimini
  13. 13AOU, Cagliari
  14. 14Osp. Civile Magg., Verona
  15. 15AO S. Maria della Misericordia, Perugia
  16. 16Arcispedale S. Maria Nuova, Reggio Emilia
  17. 17Ist. Clin. Humanitas, Milano
  18. 18Osp. Generale Moriggia-Pelascini, Gravedona
  19. 19Osp. A. Galateo, S. Cesario di Lecce
  20. 20AO Città della Salute e della Scienza, Torino
  21. 21AO, Padova
  22. 22Osp. di Bolzano, Bolzano
  23. 23Osp. G. Bosco, Torino
  24. 24P.O. “Destra Secchia”, Pieve di Coriano
  25. 25Pol. di Bari, Bari
  26. 26AO Rummo, Benevento
  27. 27U. of Florence, Firenze
  28. 28Sapienza U., Roma, Italy


Background Subclinical synovial inflammation detected by ultrasonography (US) in patients with rheumatoid arthritis (RA) in clinical remission relates to disease flare. The impact of tenosynovitis in this context is not known.

Objectives To evaluate the association between US-detected tenosynovitis and synovitis in RA patients in clinical remission and flare over 12-months.

Methods STARTER is a multicentre cohort study of the US Study Group of the Italian Society for Rheumatology. Participants were selected on the basis of a reliability exercise and the availability of high-end equipment. Patients with RA in clinical remission underwent clinical evaluation and US synovitis (-S) and tenosynovitis (-T) were assessed categorically for Grey Scale (GS) and power Doppler (PD) at 11 joints, extensor and flexor tendons in both hands and wrists. Patients were seen at 6 and 12 months. Flare within 12 months was defined as increase of >1.2 or >0.6 if final DAS28>3.2. The relationship between the presence of GS-T/-S, PD-T/-S was evaluated by logistic models, presented as odds ratios (OR) and 95% confidence interval (CI), adjusted for pre-specified confounders.

Results 361 patients (72.3% f, mean age (sd) 56.1 (13.3), median disease duration (IQR) 7.1 years (3.6–13.5)) were included. 98/326 (30.6%) patients had a flare within 12 months. Considering US variables separately, only PD-S significantly predicted flare (OR 1.87 (1.12,3.14)). When the model included both –T and –S, only the concurrent presence of –T and –S predicted flare (PD-T+-S: OR 2.06 (1.04, 4.07); GS-T+-S: OR 2.27, (1.01,5.10)), while isolated –S and –T did not.

Conclusions In patients with RA in clinical remission, US-detected synovial and tenosynovial inflammation identifies patients at risk of flare. US might help decisions on management in this population.

Disclosure of Interest None declared

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