Residual inflammation in psoriatic arthritis patients in stable minimal disease activity
BackgroundIn psoriatic arthritis (PsA), low disease activity as defined by the Minimal Disease Activity (MDA) index is considered a good treatment target. However, as MDA is based only on clinical findings, it might not capture pauci-symptomatic inflammation. Sensitive imaging such as ultrasound (US...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-12-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.1096547/full |
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| author | Pierluigi Macchioni Antonio Marchesoni Antonio Marchesoni Giovanni Ciancio Gilda Sandri Alen Zabotti Gentiana Vukatana Luca Montaguti Mariacristina Focherini Marcello Govoni Amelia Spinella Nazzarena Malavolta Francesca Zuliani Marco Bruschi Fabio Mascella Carlo Salvarani Carlo Salvarani |
| author_facet | Pierluigi Macchioni Antonio Marchesoni Antonio Marchesoni Giovanni Ciancio Gilda Sandri Alen Zabotti Gentiana Vukatana Luca Montaguti Mariacristina Focherini Marcello Govoni Amelia Spinella Nazzarena Malavolta Francesca Zuliani Marco Bruschi Fabio Mascella Carlo Salvarani Carlo Salvarani |
| author_sort | Pierluigi Macchioni |
| collection | DOAJ |
| description | BackgroundIn psoriatic arthritis (PsA), low disease activity as defined by the Minimal Disease Activity (MDA) index is considered a good treatment target. However, as MDA is based only on clinical findings, it might not capture pauci-symptomatic inflammation. Sensitive imaging such as ultrasound (US) might disclose residual inflammatory signs in PsA patients in MDA.MethodsIn this cross-sectional multicentre study, adult PsA patients on biologic treatment in MDA for at least 6 months were consecutively enrolled for a thorough clinical and US examination. Data collection included demographics, personal history, main patient's reported outcomes, clinical and US findings of joints, tendon sheaths, tendons, bursae, and entheses involvement. All centers performed the US investigation in B-mode and Power Doppler (PD)-mode using a similar US machine equipped with a 18–6 and 13–5 MHz multifrequency linear probe. Statistical analysis included comparisons between groups and correlation tests.ResultsThe 72 PsA patients enrolled in the study had a median duration of MDA of 12 (6–65) months. Overall, US examination revealed a low number of acute lesions. However, 54% of patients had at least one PD signal in the examined tissues. A joint or enthesis positive PD signal was found in about 19 and 24% of patients, respectively. Synovial hypertrophy, at least one acute entheseal lesions, and bursitis were the most common changes, detected in 41.7, 41.7 and 26% of patients, respectively.ConclusionsPsA patients in a stable state of MDA may still have residual inflammation in peripheral articular structures detectable by US examination. |
| first_indexed | 2024-04-12T00:54:10Z |
| format | Article |
| id | doaj.art-ed8bd215f0b2455da0c2d286edc3ed5c |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-12T00:54:10Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-ed8bd215f0b2455da0c2d286edc3ed5c2022-12-22T03:54:40ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-12-01910.3389/fmed.2022.10965471096547Residual inflammation in psoriatic arthritis patients in stable minimal disease activityPierluigi Macchioni0Antonio Marchesoni1Antonio Marchesoni2Giovanni Ciancio3Gilda Sandri4Alen Zabotti5Gentiana Vukatana6Luca Montaguti7Mariacristina Focherini8Marcello Govoni9Amelia Spinella10Nazzarena Malavolta11Francesca Zuliani12Marco Bruschi13Fabio Mascella14Carlo Salvarani15Carlo Salvarani16Rheumatology Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, ItalyRheumatology Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, ItalyRheumatology, Humanitas San Pio X, Milan, ItalyDivision of Rheumatology, University Hospital of Ferrara, Ferrara, ItalyDepartment of Rheumatology, Azienda Policlinico di Modena, University of Modena and Reggio Emilia, Modena, ItalyDepartment of Medical and Biological Sciences, Rheumatology Clinic, University of Udine, Udine, ItalyRheumatology Unit, S. Orsola-Malpighi Polyclinic, Bologna, ItalyRheumatology Unit, Azienda USL di Cesena, Cesena, ItalyRheumatology Unit, Infermi Hospital, Rimini, ItalyDivision of Rheumatology, University Hospital of Ferrara, Ferrara, ItalyDepartment of Rheumatology, Azienda Policlinico di Modena, University of Modena and Reggio Emilia, Modena, ItalyRheumatology Unit, S. Orsola-Malpighi Polyclinic, Bologna, ItalyDepartment of Medical and Biological Sciences, Rheumatology Clinic, University of Udine, Udine, ItalyRheumatology Unit, Azienda USL di Cesena, Cesena, ItalyRheumatology Unit, Infermi Hospital, Rimini, ItalyRheumatology Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, ItalyDepartment of Rheumatology, Azienda Policlinico di Modena, University of Modena and Reggio Emilia, Modena, ItalyBackgroundIn psoriatic arthritis (PsA), low disease activity as defined by the Minimal Disease Activity (MDA) index is considered a good treatment target. However, as MDA is based only on clinical findings, it might not capture pauci-symptomatic inflammation. Sensitive imaging such as ultrasound (US) might disclose residual inflammatory signs in PsA patients in MDA.MethodsIn this cross-sectional multicentre study, adult PsA patients on biologic treatment in MDA for at least 6 months were consecutively enrolled for a thorough clinical and US examination. Data collection included demographics, personal history, main patient's reported outcomes, clinical and US findings of joints, tendon sheaths, tendons, bursae, and entheses involvement. All centers performed the US investigation in B-mode and Power Doppler (PD)-mode using a similar US machine equipped with a 18–6 and 13–5 MHz multifrequency linear probe. Statistical analysis included comparisons between groups and correlation tests.ResultsThe 72 PsA patients enrolled in the study had a median duration of MDA of 12 (6–65) months. Overall, US examination revealed a low number of acute lesions. However, 54% of patients had at least one PD signal in the examined tissues. A joint or enthesis positive PD signal was found in about 19 and 24% of patients, respectively. Synovial hypertrophy, at least one acute entheseal lesions, and bursitis were the most common changes, detected in 41.7, 41.7 and 26% of patients, respectively.ConclusionsPsA patients in a stable state of MDA may still have residual inflammation in peripheral articular structures detectable by US examination.https://www.frontiersin.org/articles/10.3389/fmed.2022.1096547/fullpsoriatic arthritisultrasonographyminimal disease activitysynovitisenthesitis |
| spellingShingle | Pierluigi Macchioni Antonio Marchesoni Antonio Marchesoni Giovanni Ciancio Gilda Sandri Alen Zabotti Gentiana Vukatana Luca Montaguti Mariacristina Focherini Marcello Govoni Amelia Spinella Nazzarena Malavolta Francesca Zuliani Marco Bruschi Fabio Mascella Carlo Salvarani Carlo Salvarani Residual inflammation in psoriatic arthritis patients in stable minimal disease activity Frontiers in Medicine psoriatic arthritis ultrasonography minimal disease activity synovitis enthesitis |
| title | Residual inflammation in psoriatic arthritis patients in stable minimal disease activity |
| title_full | Residual inflammation in psoriatic arthritis patients in stable minimal disease activity |
| title_fullStr | Residual inflammation in psoriatic arthritis patients in stable minimal disease activity |
| title_full_unstemmed | Residual inflammation in psoriatic arthritis patients in stable minimal disease activity |
| title_short | Residual inflammation in psoriatic arthritis patients in stable minimal disease activity |
| title_sort | residual inflammation in psoriatic arthritis patients in stable minimal disease activity |
| topic | psoriatic arthritis ultrasonography minimal disease activity synovitis enthesitis |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.1096547/full |
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