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Posted by on May 14, 2017 in Rheumatoid Arthritis | 0 comments

In a nutshell

The study looked at increases in bone erosion and swelling using body imaging scans in patients with rheumatoid arthritis that were in remission. The authors concluded that up to 40% of patients in remission showed increases in bone erosion.

Some background

In rheumatoid arthritis (RA) patients experience inflammation and pain in their joints. While RA patients in remission do not show any symptoms, they may still experience temporary increases in disease activity known as flares. Continuous remission is the most desirable outcome from treatment.

Silent progression of RA can be detected by magnetic resonance imaging (MRI) scans, a type of body imaging technique. These scans can show any increases in bone erosion, swelling of joints, or fluid in the bone marrow (known as bone marrow edema). Patients experiencing silent progression of RA may require further treatment.

Methods & findings

80 RA patients who were good candidates to achieve remission were included in this study. All patients underwent 2 MRI scans, 1 year apart, of the hand and wrist of their dominant hand. Disease activity scores were recorded at the time of each scan.

71 patients (89%) showed an improvement in disease activity at 1 year. 73% of these patients showed improvements in both MRI scan results and in disease activity scores. However, 24% of patients showed a silent progression of RA (based on MRI results) despite improvements in disease activity. 3% of patients showed equal values in both.
 
48% of patients with improvements in disease activity achieved remission at 1 year (based on standard criteria). Of these, 41% showed increases in bone erosion at 1 year, 39% showed less erosion, while the rest stayed the same.

The bottom line

The authors concluded that up to 40% of RA patients who are considered in remission showed increases in bone erosion at 1 year.

Published By :

BMC musculoskeletal disorders

Date :

Apr 19, 2017

Original Title :

Silent progression in patients with rheumatoid arthritis: is DAS28 remission an insufficient goal in RA? Results from the German Remission-plus cohort.

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