Ultrasonography predicts achievement of Boolean remission after DAS28-based clinical remission of rheumatoid arthritis

<p><i>Objectives.</i> To determine whether ultrasonography (US) predicts Boolean remission in rheumatoid arthritis (RA) patients who had achieved disease activity score in 28 joints (DAS28)-based remission criteria.</p> <p><i>Methods.</i> Thirty-one RA patients in DAS28-based clinical remission were recruited. US semiquantitatively determined Gray scale (GS) and power Doppler (PD) signal scores in the bilateral wrists and all metacarpophalangeals and proximal interphalangeals. Total GS score and total PD score were calculated as the sum of individual scores for each joint.</p> <p><i>Results.</i> Among 22 RA patients, who maintained DAS28 remission for 2 years, 16 met Boolean remission criteria at the end of study. Both total GS and total PD scores at baseline were significantly lower in Boolean remission group than non-remission group. There was no significant difference in other baseline parameters, including duration of disease, duration of remission, mTSS, and disease activity composite parameters between the two groups. Among the factors for Boolean remission criteria at 2 years, patient global assessment score was associated with total GS score at the entry, while swollen joint count was related to total PD score.</p> <p><i>Conclusions.</i> Null or low grade of GS and PD findings in US are associated with achieving Boolean remission. Thus, US is essential for assessment and prediction of “deeper remission” of RA.</p

¹⁸F-FDG and ¹⁸F-NaF PET/CT demonstrate coupling of inflammation and accelerated bone turnover in rheumatoid arthritis

<p><i>Objective.</i> To compare the findings in rheumatoid arthritis (RA)-affected joints between ¹⁸F-fluorodeoxyglucose (FDG) and ¹⁸F-fluoride (NaF) positron emission tomography (PET)/computed tomography (CT).</p> <p><i>Methods.</i> We enrolled twelve RA patients who started a new biologic agent (naïve 9 and switch 3). At entry, both hands were examined by ¹⁸F-FDG PET/CT, ¹⁸F-NaF PET/CT, and X-ray. Intensity of PET signals was determined by standardized uptake value max (SUVmax) in metacarpophalangeal (MCP), proximal interphalangeal (PIP), and ulnar, medial, and radial regions of the wrists. Hand X-rays were evaluated according to the Genant-modified Sharp score at baseline and 6 months.</p> <p><i>Results.</i> Both ¹⁸F-FDG and ¹⁸F-NaF accumulated in RA-affected joints. The SUVmax of ¹⁸F-FDG correlated with that of ¹⁸F-NaF in individual joints (<i>r</i> = 0.65), though detail distribution was different between two tracers. ¹⁸F-NaF and ¹⁸F-FDG signals were mainly located in the bone and the surrounding soft tissues, respectively. The sum of SUVmax of ¹⁸F-NaF correlated with disease activity score in 28 joint (DAS28), modified health assessment questionnaire (MHAQ), and radiographic progression. ¹⁸F-FDG and ¹⁸F-NaF signals were associated with the presence of erosions, particularly progressive ones.</p> <p><i>Conclusion.</i> Our data show that both ¹⁸F-FDG and ¹⁸F-NaF PET signals were associated with RA-affected joints, especially those with ongoing erosive changes.</p

Additional file 2: Table S2. of Continuous evolution of clinical phenotype in 578 Japanese patients with Behçet’s disease: a retrospective observational study

Phenotype of patients with BD treated with biologic agents. (DOC 29 kb

Additional file 3: Table S3. of Continuous evolution of clinical phenotype in 578 Japanese patients with Behçet’s disease: a retrospective observational study

Rate of therapeutic agents use in groups with different date of onset. (DOC 31 kb