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Prediction of recurrence and remission using superb microvascular imaging in rheumatoid arthritis

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Abstract

Purpose

Ultrasound is commonly used to assess the degree of synovitis in patients with rheumatoid arthritis (RA); however, it is unclear which joints are optimal for evaluating and predicting recurrence and remission.

Patients and methods

In 293 RA patients enrolled in the KURAMA cohort, 28 joints were assessed by ultrasound.

Results

Results from patients in remission in both 2015 and 2017 (Group 1, n = 152) were compared with those from patients in remission in 2015 and non-remission in 2017 (Group 2, n = 60). The SMI scores for total (3.1 vs. 6.3, P = 0.004), MCP2-5 (1.1 vs. 2.4, P = 0.03), wrist (0.9 vs. 2.1, P = 0.0003), MTP2-5 (0.4 vs. 1.0, P = 0.03), and Lisfranc joints (0.07 vs. 0.25, P = 0.04) were significantly higher for Group 2. When those in non-remission in 2015 and remission in 2017 (Group 3, n = 27) were compared with those in remission in 2015 and non-remission in both 2015 and 2017 (Group 4, n = 54), the GS–SMI combined score (3.0 vs. 5.0, P = 0.04) and SMI score (1.5 vs. 2.9, P = 0.04) for MCP2-5 joints were significantly higher for Group 4. Multivariate logistic regression analysis identified “wrist SMI score ≧ 1” as an independent prognostic factor for recurrence (odds ratio 3.08, P = 0.001) and “MCP2-5 GS–SMI combined score ≦ 4” as an independent prognostic factor for remission (odds ratio 3.25, P = 0.048).

Conclusion

We identified the optimal joint cut-off scores for predicting recurrence and remission in RA patients. Risk-stratification therapy based on the ultrasound scores may improve outcome and quality of life for patients with RA.

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Acknowledgements

This work was supported by a Grant from the JSPS KAKENHI (18K12103).

Author information

Authors and Affiliations

  1. Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Syogoin, Sakyoku, Kyoto, 606-8507, Japan

    Hidemasa Matsuo, Akari Imamura, Madoka Shimizu, Maiko Inagaki, Yuko Tsuji & Yasutomo Fujii

  2. Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Shuichiro Nakabo & Tsuneyo Mimori

  3. Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Motomu Hashimoto, Hiromu Ito & Tsuneyo Mimori

  4. Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Hiromu Ito

  5. Department of Clinical Biostatistics, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Shiro Tanaka

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  1. Hidemasa Matsuo
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  3. Madoka Shimizu
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Contributions

HM, AI, MS, MI, YT, and SN have contributed to data collection. HM, AI, SN, MH, and HI have contributed to analysis and interpretation of data. ST helped with statistical analyses. HM, MH, HI, TM, and YF designed and supervised the project. HM wrote the manuscript. All authors critically reviewed and approved the final version of the manuscript.

Corresponding author

Correspondence to Hidemasa Matsuo.

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Conflict of interest

M.H., H.I., and T.M. belong to a department that is financially supported by four pharmaceutical companies (Tanabe-Mitsubishi, Chugai, UCB Japan, and Ayumi). M.H. receives research grants and/or speaker honoraria from Astellas, Tanabe-Mitsubishi, Eisai, and Bristol-Meyers. H.I. receives research grants and/or speaker fee from BMS, Astellas, Asahi-Kasei, and Kyocera Medical. The KURAMA cohort study is supported by a grant from Daiichi-Sankyo. The present study is conducted as an investigator-initiated study. These companies have no role in the design of the study, the collection or analysis of the data, the writing of the manuscript, or the decision to submit the manuscript for publication. H.M., A.I., M.S., M.I., Y.T., S.N., S.T., and Y.F. have no competing financial interests to declare.

Ethical statements

The study was conducted in accordance with the principles set down in the Declaration of Helsinki and was approved by the ethics committee of Kyoto University (R0357). All patients provided written informed consent.

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10396_2019_978_MOESM1_ESM.pptx

Supplementary Figure. Detailed information about drug usage in each group. Venn diagram showing drug use by each group in 2015. (PPTX 70 kb)

Supplementary material 2 (PDF 352 kb)

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Matsuo, H., Imamura, A., Shimizu, M. et al. Prediction of recurrence and remission using superb microvascular imaging in rheumatoid arthritis. J Med Ultrasonics 47, 131–138 (2020). https://doi.org/10.1007/s10396-019-00978-8

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  • DOI: https://doi.org/10.1007/s10396-019-00978-8

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