Matteo Piga1, Alessandra Gabba2, Mattia Congia2, Fabiana Figus2, Alberto Cauli2, Alessandro Mathieu2. 1. Chair of Rheumatology and Rheumatology Unit, University Clinic AOU of Cagliari, SS 554-09 042 Monserrato, Cagliari, Italy. Electronic address: matteopiga@alice.it. 2. Chair of Rheumatology and Rheumatology Unit, University Clinic AOU of Cagliari, SS 554-09 042 Monserrato, Cagliari, Italy.
Abstract
OBJECTIVE: To investigate the prognostic value of US in predicting musculoskeletal flares and Jaccoud׳s arthropathy (JA) in systemic lupus erythematosus (SLE). METHODS: A total of 80 out of 94 patients (76 female; age 45.5 ± 13.2 years) with non-deforming non-erosive (NDNE) arthritis and 48/60 healthy controls (42 female; age 49.6 ± 11.6 years) completed the 5-year follow-up study. Each patient was prospectively assessed for the occurrence of musculoskeletal flares using BILAG2004 and hand deformities according to Jaccoud׳s articular index. Baseline clinical, serological, semi-quantitative (0-3 scale) ultrasound (US) findings, PD-synovitis and PD-tenosynovitis scores were used as covariates to identify predictors of study outcomes. Short Form 36 v2 (SF36v2) health survey questionnaire was administered. RESULTS: Overall, 12 MS flares in 10 (12.5%) patients were recorded and the incidence rate was 3.0 per 100 patient-year. Baseline PD-synovitis score independently predicted MS flare (p < 0.001; RR = 2.0; 95% CI: 1.4-3.0) within 2 years since US examination. In all, 5 (6.2%) patients developed JA whose incidence rate was 1.25 per 100 patient-year. Independent risk factors for development of JA were higher longitudinal BILAG score in the musculoskeletal domain (p = 0.005; RR = 2.4; 95% CI: 1.3-4.6) and longer disease duration (p = 0.013; RR 1.2; 95% CI: 1.1-1.3). JA and active musculoskeletal inflammation (BILAG ≥ C), but not US erosions, were associated with lower results in SF36v2 physical and mental summary components. CONCLUSIONS: Performing musculoskeletal US can be useful in order to predict MS flares. Jaccoud׳s deformities may arise in patients with long-standing SLE and prolonged, even subclinical, joint and tendon inflammation.
OBJECTIVE: To investigate the prognostic value of US in predicting musculoskeletal flares and Jaccoud׳s arthropathy (JA) in systemic lupus erythematosus (SLE). METHODS: A total of 80 out of 94 patients (76 female; age 45.5 ± 13.2 years) with non-deforming non-erosive (NDNE) arthritis and 48/60 healthy controls (42 female; age 49.6 ± 11.6 years) completed the 5-year follow-up study. Each patient was prospectively assessed for the occurrence of musculoskeletal flares using BILAG2004 and hand deformities according to Jaccoud׳s articular index. Baseline clinical, serological, semi-quantitative (0-3 scale) ultrasound (US) findings, PD-synovitis and PD-tenosynovitis scores were used as covariates to identify predictors of study outcomes. Short Form 36 v2 (SF36v2) health survey questionnaire was administered. RESULTS: Overall, 12 MS flares in 10 (12.5%) patients were recorded and the incidence rate was 3.0 per 100 patient-year. Baseline PD-synovitis score independently predicted MS flare (p < 0.001; RR = 2.0; 95% CI: 1.4-3.0) within 2 years since US examination. In all, 5 (6.2%) patients developed JA whose incidence rate was 1.25 per 100 patient-year. Independent risk factors for development of JA were higher longitudinal BILAG score in the musculoskeletal domain (p = 0.005; RR = 2.4; 95% CI: 1.3-4.6) and longer disease duration (p = 0.013; RR 1.2; 95% CI: 1.1-1.3). JA and active musculoskeletal inflammation (BILAG ≥ C), but not US erosions, were associated with lower results in SF36v2 physical and mental summary components. CONCLUSIONS: Performing musculoskeletal US can be useful in order to predict MS flares. Jaccoud׳s deformities may arise in patients with long-standing SLE and prolonged, even subclinical, joint and tendon inflammation.
Authors: Natalia Mena-Vázquez; Antonio Fernández-Nebro; José María Pego-Reigosa; María Galindo; Ana Melissa-Anzola; Esther Uriarte-Isacelay; Alejandro Olivé-Marqués; Elena Aurrecoechea; Mercedes Freire; Eva Tomero; María Jesús García-Villanueva; Claudia Stoye; Esteban Salas-Heredia; Jose Antonio Bernal-Vidal; Eva Salgado; Ricardo Blanco; Francisco Javier Novoa; Mónica Ibáñez-Barcelo; Vicente Torrente-Segarra; Javier Narvaez; Joan Calvet; Clara Moriano Morales; Tomas Ramon Vazquez-Rodriguez; Paloma Garcia de la Peña; Cristina Bohórquez; José Luis Andreu-Sánchez; Tatiana Cobo-Ibañez; Gema Bonilla; Nuria Lozano-Rivas; Carlos Montilla; Francisco Javier Toyos; Jose Luis Marenco De la Fuente; Lorena Expósito; María Esther Ruiz-Lucea; Elia Vals; Javier Manero-Ruiz; Jose A Bernal-Vidal; Iñigo Rua-Figueroa Journal: Rheumatology (Oxford) Date: 2020-08-01 Impact factor: 7.580