Persistant Synovitis of Rheumatoid Arthritis in Remission

There has been a study on persistence of ultrasound synovitis in patients with rheumatoid arthritis fulfilling DAS and/or ACR/EULAR remission criteria presented at the EULAR 2012 meeting in Berlin. P. Zufferey and colleagues looked at patients fulfilling remission criteria with a semi-quantitative ultrasound score using the OMERACT criteria for synovitis in rheumatoid arthritis. The abstract looks a bit complicated, but the authors defined a cut-off and found that 33% of the patients still showed signs of ultrasound synovitis, which means that a state of low activity instead of a true remission would be a better description.


[OP0275] PERSISTENCE OF ULTRASOUND SYNOVITIS IN THE PATIENTS FULLFILING THE DAS AND/OR THE NEW ACR/EULAR RA REMISSION DEFINITIONS: RESULTS OF THE SONAR SCORE APPLIED TO THE PATIENTS OF THE SCQM COHORT
P. Zufferey1, B. Möller2, L. Brulhart3, G. Tamborrini4, A. Scherer5, H.R. Ziswiler2, for the Rheumatologists of SCQM. 1Dal, CHUV, Lausanne; 2Rheumatology, Inselspital, Bern; 3Rheumatology, HUG, Geneva; 4Rheumatology, Universitat Spital; 5SCQM, Zurich, Switzerland
Conclusions: This study shows that the SONAR score applied by different examinators to RA patients is not different in those fulfilling the DAS remission and the new ACR/EULAR criteria. More than a third of all RA patients in clinical remission (either DAS or ACR/EULAR) still present signs of ultrasound synovitis suggesting that they have reached a low activity instead of a true remission state.


Aiming at remission should still be our goal in treating rheumatoid arthritis, but we should be aware that this might mean for the individual patient reaching the lowest state of disease activity possible.