Can ultrasound of the joints predict remission in rheumatoid arthritis?

This study investigated if an ultrasound of the joints (musculoskeletal) can predict if remission can be achieved in patients with rheumatoid arthritis (RA). They found that ultrasound can predict if a patient with RA will achieve remission.

The aim of treatment for rheumatoid arthritis (RA) is to reduce disease activity. Medication is used to reduce symptoms such as pain and inflammation in the joints. These medications are called disease-modifying antirheumatic drugs or DMARDs.

Usually, the doctor measures how severe a patient’s symptoms are through the disease activity score of 28 joints (DAS28). Musculoskeletal ultrasound (MSUS) is a tool that provides images of the joints. A doctor can also assess disease activity from these images. How useful MSUS is to predict how fast or severe RA will progress or if a patient will achieve remission remains under investigation.

This study included 141 patients with RA. Patients underwent MSUS at the beginning of the study and again at 1, 3, 6 and 12 months. Information on medication was included in the analysis. Patients were grouped based on the type of DMARDs they were taking – synthetic (s) or biological (b). Disease activity was measured by the DAS28 at all time points.

49.2% of patients in the bDMARD group and 43.6% of patients in the sDMARD group achieved remission at 12 months. The likelihood of achieving remission was significantly greater in patients with lower disease activity at the beginning of the study, shorter disease duration and with lower MSUS scores.

The authors concluded that musculoskeletal ultrasound can predict if a patient with RA will achieve remission after 1 year of treatment.

This study included a small sample of patients. Larger studies are needed to determine if MSUS is a useful predictor of disease progression in patients with RA.

If you have any questions related to rheumatoid arthritis treatment please discuss this with your physician.