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Bosch, P; Husic, R; Ficjan, A; Gretler, J; Lackner, A; Graninger, WB; Duftner, C; Hermann, J; Dejaco, C.
Evaluating current definitions of low disease activity in psoriatic arthritis using ultrasound.
Rheumatology (Oxford). 2019; 58(12):2212-2220 Doi: 10.1093/rheumatology/kez237
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Führende Autor*innen der Med Uni Graz
Bosch Philipp
Dejaco Christian
Co-Autor*innen der Med Uni Graz
Ficjan Anja
Graninger Winfried
Gretler Judith
Hermann Josef
Husic Rusmir
Lackner Angelika
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Abstract:
OBJECTIVE: To evaluate low disease activity (LDA) cut-offs in psoriatic arthritis (PsA) using ultrasound. METHODS: Eighty-three PsA patients underwent clinical and ultrasound examinations at two visits. LDA was assessed using the Disease Activity index for Psoriatic Arthritis (DAPSA ⩽ 14), the Psoriatic ArthritiS Disease Activity Score (PASDAS ⩽ 3.2), the Composite Psoriatic Disease Activity Index ⩽ 4, the DAS28-CRP ⩽ 2.8 and the minimal disease activity criteria. Ultrasound was performed at 68 joints and 14 entheses. Minimal ultrasound disease activity (MUDA-j/e) was defined as a Power Doppler score ⩽ 1, respectively at joints, paratendinous tissue, tendons and entheses. A global ultrasound score was calculated by summing Grey Scale and Power Doppler information (GUIS-j/e). RESULTS: LDA was present in 33.7-65.0% at baseline and in 44.3-80.6% at follow-up, depending on the criteria used. MUDA-j/e was observed in 16.9% at baseline and in 30% at follow-up. GUIS-j/e was significantly higher in patients with moderate/high disease activity vs LDA according to DAPSA and PASDAS at baseline and DAPSA, PASDAS, Composite Psoriatic Disease Activity Index and minimal disease activity at follow-up. Patients in moderate/high disease activity had MUDA-j/e in 8.1-21.4% at baseline and in 8.3-20.0% at follow-up, depending on the applied clinical composite. MUDA-j/e patients with moderate/high disease activity had higher levels of pain and pain-related items than those with LDA. CONCLUSION: The LDA cut-offs of DAPSA, PASDAS, Composite Psoriatic Disease Activity Index, minimal disease activity, but not DAS28-CRP are capable of distinguishing between high and low ultrasound activity. Pain and pain-related items are the main reason why PsA patients without signs of ultrasound inflammation are classified with higher disease activity.
Find related publications in this database (using NLM MeSH Indexing)
Arthritis, Psoriatic - diagnosis
Disease Progression - administration & dosage
Female - administration & dosage
Follow-Up Studies - administration & dosage
Humans - administration & dosage
Joints - diagnostic imaging
Male - administration & dosage
Prospective Studies - administration & dosage
ROC Curve - administration & dosage
Severity of Illness Index - administration & dosage
Ultrasonography, Doppler - methods

Find related publications in this database (Keywords)
psoriatic arthritis
outcome measures
disease activity
ultrasonography
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