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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
Web of Science
PubMed
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- Führende Autor*innen der Med Uni Graz
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Bosch Philipp
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Dejaco Christian
- Co-Autor*innen der Med Uni Graz
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Ficjan Anja
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Graninger Winfried
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Gretler Judith
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Hermann Josef
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Husic Rusmir
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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)
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Arthritis, Psoriatic - diagnosis
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Disease Progression - administration & dosage
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Female - administration & dosage
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Follow-Up Studies - administration & dosage
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Humans - administration & dosage
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Joints - diagnostic imaging
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Male - administration & dosage
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Prospective Studies - administration & dosage
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ROC Curve - administration & dosage
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Severity of Illness Index - administration & dosage
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Ultrasonography, Doppler - methods
- Find related publications in this database (Keywords)
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psoriatic arthritis
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outcome measures
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disease activity
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ultrasonography