التفاصيل البيبلوغرافية
| العنوان: |
Ultrasound in anti-CCP+ at-risk individuals without clinical synovitis: development of a novel 6-joint protocol for feasible risk prediction. |
| المؤلفون: |
Matteo, Andrea Di, Lorenzis, Enrico De, Duquenne, Laurence, Nam, Jacqueline L, Garcia-Montoya, Leticia, Harnden, Kate, Chowdhury, Rahaymin, Wakefield, Richard J, Emery, Paul, Mankia, Kulveer |
| المصدر: |
Rheumatology; Aug2024, Vol. 63 Issue 8, p2213-2221, 9p |
| مصطلحات موضوعية: |
RISK assessment, RESEARCH funding, T-test (Statistics), RHEUMATOID arthritis, AUTOANTIBODIES, MUSCULOSKELETAL system diseases, FISHER exact test, LOGISTIC regression analysis, ULTRASONIC imaging, DESCRIPTIVE statistics, CHI-squared test, MANN Whitney U Test, KAPLAN-Meier estimator, LOG-rank test, ODDS ratio, DATA analysis software, CONFIDENCE intervals, SYMPTOMS |
| مستخلص: |
Objectives To investigate, in anti-CCP antibody–positive individuals with musculoskeletal symptoms but no clinical synovitis (CCP+ at-risk), the additional value of US for the prediction of inflammatory arthritis. Furthermore, to define a concise US protocol for feasible risk prediction. Methods Demographic and clinical data were collected in 417 CCP+ at-risk (Leeds CCP cohort) with a baseline US scan assessing synovitis and bone erosions in 36 joints, and a follow-up duration ≥24 months. Multivariable binary regression models for inflammatory arthritis development at 24 months evaluated routine clinical variables associated with inflammatory arthritis alone ('clinical' model) and combined with a 36-joint US scanning protocol ('clinical-US extended' model). A 'clinical-US short' model was also developed. Results At 24 months, 92/417 (22.1%) CCP+ at-risk developed inflammatory arthritis (median time 7 months, interquartile range 3–12). The 'clinical-US extended' model performed better than the 'clinical' model [area under the curve (AUC) 0.788 vs AUC 0.731, respectively, P < 0.001] with an odds ratio for inflammatory arthritis development of 3.18 (95% CI 1.80–5.63) for US synovitis and 2.54 (95% CI 1.21–5.37) for bone erosions. The 'clinical-US short' model, which retained the wrists, knees and MTP5 joints, performed better (AUC 0.782) than the 'clinical' model (P < 0.001) and similarly (difference in Akaike information criteria <2) to the 'clinical-US extended' model. Conclusions US provides valuable information for predicting progression to inflammatory arthritis in CCP+ individuals both alone and in addition to clinical variables. US synovitis was associated with a 3-fold increase risk of inflammatory arthritis development. A concise US protocol of six joints provides clinically feasible risk prediction in CCP+ at-risk. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
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