Rheumatoid Arthritis Clinical Trial
Official title:
Sensitivity to Change of Different Reduced Ultrasound Counts in Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by intra and
peri-articular synovial inflammation. Synovitis can damage the articular cartilage, bones,
joint capsule, tendons and ligaments leading to the consequential functional joint
deterioration.
The main goal of RA treatment is to achieve disease remission. The treatment of RA consists
of synthetic and biologic disease modifying drugs (DMARDs), being the second ones selected
when low disease or remission is not achieved with the first ones. Therapeutic response
monitoring in RA should be closely managed. It is classically based on clinical exploration
and laboratory tests. During the last decade, the resolution improvement of musculoskeletal
ultrasound (MSUS) imaging has led to the gradual incorporation of this technique in the
evaluation and monitoring of patients with RA, mainly due to its better capacity to detect
synovitis than clinical exploration . Ultrasound imaging is highly available, non-invasive,
reproducible, affordable and well accepted by patients. Ultrasound doppler mode detects
pathological synovial flow, which reflects synovial inflammation and has a demonstrated
sensitivity to change in multiple longitudinal studies. Sonographic evaluation of patients
with RA includes the detection of synovitis in B and Doppler mode in the joints accessible
by ultrasound. There has been high variability in the literature regarding the number of
joints that should be evaluated for an appropriate monitoring of the RA patients. The
validity for monitoring the therapeutic response in long standing RA has been demonstrated
in three reduced joint counts, including 12, 7 and 6 joints. However, in shorter evolution
RA, the sensitivity to change of any of these reduced ultrasound evaluations has never been
studied
Primary objectives
• To evaluate the sensitivity to change of the Doppler Ultrasound evaluation of 12, 7 and 6
joints counts in RA patients with more than 6 months and less than 5 years of evolution,
which initiate an effective treatment for the disease according to indication (biologic
DMARD in monotherapy or combined with methotrexate).
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