TY - JOUR T1 - The predictive role of ultrasound-detected tenosynovitis and joint synovitis for flare in patients with rheumatoid arthritis in stable remission. Results of an Italian multicentre study of the Italian Society for Rheumatology Group for Ultrasound: the STARTER study JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis DO - 10.1136/annrheumdis-2018-213217 SP - annrheumdis-2018-213217 AU - Georgios Filippou AU - Garifallia Sakellariou AU - Carlo Alberto Scirè AU - Greta Carrara AU - Federica Rumi AU - Emanuela Bellis AU - Antonella Adinolfi AU - Alberto Batticciotto AU - Alessandra Bortoluzzi AU - Giovanni Cagnotto AU - Marta Caprioli AU - Marco Canzoni AU - Francesco Paolo Cavatorta AU - Orazio De Lucia AU - Valentina Di Sabatino AU - Antonella Draghessi AU - Ilaria Farina AU - Maria Cristina Focherini AU - Alessandra Gabba AU - Marwin Gutierrez AU - Luca Idolazzi AU - Filippo Luccioli AU - Pierluigi Macchioni AU - Marco Sergio Massarotti AU - Claudio Mastaglio AU - Luana Menza AU - Maurizio Muratore AU - Simone Parisi AU - Valentina Picerno AU - Matteo Piga AU - Roberta Ramonda AU - Bernd Raffeiner AU - Daniela Rossi AU - Silvia Rossi AU - Paola Rossini AU - Crescenzio Scioscia AU - Carlo Venditti AU - Alessandro Volpe AU - Annamaria Iagnocco Y1 - 2018/06/09 UR - http://ard.bmj.com/content/early/2018/06/09/annrheumdis-2018-213217.abstract N2 - Objective To define the role of ultrasound (US) for the assessment of patients with rheumatoid arthritis (RA) in clinical remission, including joint and tendon evaluation.Methods A multicentre longitudinal study has been promoted by the US Study Group of the Italian Society for Rheumatology. 25 Italian centres participated, enrolling consecutive patients with RA in clinical remission. All patients underwent complete clinical assessment (demographic data, disease characteristics, laboratory exams, clinical assessment of 28 joints and patient/physician-reported outcomes) and Power Doppler (PD) US evaluation of wrist, metacarpalphalangeal joints, proximal interphalangeal joints and synovial tendons of the hands and wrists at enrolment, 6 and 12 months. The association between clinical and US variables with flare, disability and radiographic progression was evaluated by univariable and adjusted logistic regression models.Results 361 patients were enrolled, the mean age was 56.20 (±13.31) years and 261 were women, with a mean disease duration of 9.75 (±8.07) years. In the 12 months follow-up, 98/326 (30.1%) patients presented a disease flare. The concurrent presence of PD positive tenosynovitis and joint synovitis predicted disease flare, with an OR (95% CI) of 2.75 (1.45 to 5.20) in crude analyses and 2.09 (1.06 to 4.13) in adjusted analyses. US variables did not predict the worsening of function or radiographic progression. US was able to predict flare at 12 months but not at 6 months.Conclusions PD positivity in tendons and joints is an independent risk factor of flare in patients with RA in clinical remission. Musculoskeletal ultrasound evaluation is a valuable tool to monitor and help decision making in patients with RA in clinical remission. ER -