Anna-Birgitte Aga1, Hilde Berner Hammer1, Inge Christoffer Olsen1, Till Uhlig1, Tore K Kvien1, Désirée van der Heijde2, Hallvard Fremstad3, Tor Magne Madland4, Åse Stavland Lexberg5, Hilde Haukeland6, Erik Rødevand7, Christian Høili8, Hilde Stray9, Anne Noraas Bendvold10, Dag Magnar Soldal11, Gunnstein Bakland12, Elisabeth Lie1, Espen A Haavardsholm1. 1. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. 2. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. 3. Department of Rheumatology, Ålesund Hospital, Helse Møre og Romsdal HF, Ålesund, Norway. 4. Department of Rheumatology, Haukeland University Hospital, Helse Bergen HF, Bergen, Norway. 5. Department of Rheumatology, Drammen Hospital, Vestre Viken HF, Drammen, Norway. 6. Department of Rheumatology, Martina Hansens Hospital AS, Bærum, Norway. 7. Department of Rheumatology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. 8. Department of Rheumatology, Hospital Østfold HF, Moss, Norway. 9. Haugesund Rheumatism HospitalAS, Haugesund, Norway. 10. The Rheumatology Clinic Dovland/Bendvold, Kristiansand, Norway. 11. Department of Rheumatology, Sørlandet Hospital HF, Kristiansand, Norway. 12. Department of Rheumatology, University Hospital of North Norway, Tromsø, Norway Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway.
Abstract
OBJECTIVES: To develop and validate candidate sets of joints and tendons for assessment of ultrasound (US) joint inflammation in rheumatoid arthritis (RA). METHODS: Patients were included in one of two cohorts from 2010 to June 2013: disease-modifying antirheumatic drug naïve early RA or established RA starting/switching biologics. An extensive US examination was performed by experienced sonographers using a validated grey-scale (GSUS) and power Doppler (PDUS) semiquantitative scoring system with scores 0-3 for both GSUS and PDUS in 36 joints and four tendons. We performed factor analysis in the early RA US data and selected candidate joint/tendon sets based on these results. The proportion of information in the total US scores retained in these candidate sets was assessed by R(2) from linear regression analysis. Finally, the candidate sets and previously proposed joint scores were tested in the established RA cohort, and we also evaluated the sensitivity to change with standardised response means. RESULTS: 227 patients with early RA and 212 patients with established RA were included. We identified two candidate sets of joints/tendons: candidate set A consisted of seven joints/two tendons (meatacarpophalangeal 1 (MCP1), MCP2, proximal interphalangeal 3, radiocarpal, elbow, metatarsophalangeal 1 (MTP1), MTP2, tibialis posterior tendon, extensor carpi ulnaris tendon) and set B of nine joints/two tendons (MCP5 and MTP5 added to set A). Unilateral reduced scores retained 78%-85% of the information in total score, while bilateral reduced scores retained 89%-93%, and both sets performed better than previously proposed reduced joint scores, and similar or slightly better regarding sensitivity to change. CONCLUSIONS: The reduced GSUS and PDUS scores retained most of the information from the total score and performed well in a validation cohort of established RA. TRIAL REGISTATION NUMBER: NCT01205854, ACTRN12610000284066. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
OBJECTIVES: To develop and validate candidate sets of joints and tendons for assessment of ultrasound (US) joint inflammation in rheumatoid arthritis (RA). METHODS: Patients were included in one of two cohorts from 2010 to June 2013: disease-modifying antirheumatic drug naïve early RA or established RA starting/switching biologics. An extensive US examination was performed by experienced sonographers using a validated grey-scale (GSUS) and power Doppler (PDUS) semiquantitative scoring system with scores 0-3 for both GSUS and PDUS in 36 joints and four tendons. We performed factor analysis in the early RA US data and selected candidate joint/tendon sets based on these results. The proportion of information in the total US scores retained in these candidate sets was assessed by R(2) from linear regression analysis. Finally, the candidate sets and previously proposed joint scores were tested in the established RA cohort, and we also evaluated the sensitivity to change with standardised response means. RESULTS: 227 patients with early RA and 212 patients with established RA were included. We identified two candidate sets of joints/tendons: candidate set A consisted of seven joints/two tendons (meatacarpophalangeal 1 (MCP1), MCP2, proximal interphalangeal 3, radiocarpal, elbow, metatarsophalangeal 1 (MTP1), MTP2, tibialis posterior tendon, extensor carpi ulnaris tendon) and set B of nine joints/two tendons (MCP5 and MTP5 added to set A). Unilateral reduced scores retained 78%-85% of the information in total score, while bilateral reduced scores retained 89%-93%, and both sets performed better than previously proposed reduced joint scores, and similar or slightly better regarding sensitivity to change. CONCLUSIONS: The reduced GSUS and PDUS scores retained most of the information from the total score and performed well in a validation cohort of established RA. TRIAL REGISTATION NUMBER: NCT01205854, ACTRN12610000284066. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Authors: Anna-Birgitte Aga; Hilde Berner Hammer; Inge Christoffer Olsen; Till Uhlig; Tore K Kvien; Désirée van der Heijde; Hallvard Fremstad; Tor Magne Madland; Åse Stavland Lexberg; Hilde Haukeland; Erik Rødevand; Christian Høili; Hilde Stray; Anne Lindtner Noraas; Inger Johanne Widding Hansen; Gunnstein Bakland; Siri Lillegraven; Elisabeth Lie; Espen A Haavardsholm Journal: RMD Open Date: 2016-12-16
Authors: Lene Terslev; Robin Christensen; Anna-Birgitte Aga; Joe Sexton; Espen A Haavardsholm; Hilde B Hammer Journal: Arthritis Res Ther Date: 2019-07-05 Impact factor: 5.156
Authors: A F Podewski; A M Glimm; I Fischer; G A W Bruyn; P Hanova; H B Hammer; A B Aga; E A Haavardsholm; S Ramiro; G R Burmester; M Backhaus; S Ohrndorf Journal: Arthritis Res Ther Date: 2022-08-05 Impact factor: 5.606