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The objective of this study is to determine the longitudinal relation between clinical remission and ultrasound (US) remission in Rheumatoid arthritis (RA).
At a patient level, US-detected residual synovitis (evaluated both by US grey-scale signals and power Doppler signals) is frequent in patients with RA in clinical remission. Several longitudinal studies reveal an association of US-detected residual synovitis and risk of relapse and radiographic progression, in individual patients and joints, over 1-2 years.
However, the longitudinal relation between clinical remission and US remission is not so well-known and it is possible that clinical remission arrive before ultrasound remission. Thus arise the question as to whether the presence of US-detected residual synovitis require to adapt the treatment to ultrasound findings or to simply increase the patient care.
The investigator propose to conduct a prospective, bi-center, non randomized study.
The study population will include all RA patient at least 18 years old in clinical remission for less than 6 month.
The primary endpoint (ability of US-detected residual synovitis to predict relapse or radiographic progression in individual patients and joints) will be evaluated afer 12 months of follow-up The total follow-up will be 12 months with a follow-up every 3 months. In addition to the standard care, each follow-up will include an ultrasound examination of 40 joints and 8 tendons
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Study patient | Other | Articular ultrasound at each study follow-up |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Articular ultrasound | Other | (Device : Ultrasound) : Articular ultrasound of the Disease Activity Score (DAS) 28 articular joint |
|
| Measure | Description | Time Frame |
|---|---|---|
| 1 year pejorative evolution | Number of patient with a clinical relapse | 1 year after inclusion |
| Measure | Description | Time Frame |
|---|---|---|
| Structural progression | Number of patient with a structural progression of the illness | 1 year after inclusion |
| RA (Rheumatoid Arthritis) remission duration | Evaluation of the remission duration (patient in both clinical and ultrasound remission) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Gaël Mouterde, MD | Montpellier University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Montpellier University Hospital | Montpellier | Herault | 34295 | France |
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| ID | Term |
|---|---|
| D001172 | Arthritis, Rheumatoid |
| D013585 | Synovitis |
| ID | Term |
|---|---|
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
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| At each follow-up (3,6,9 and 12 months after inclusion) |
| RA ultrasound remission duration | Evaluation of the ultrasound remission duration | At each follow-up (3,6,9 and 12 months after inclusion) |
| RA clinical remission duration | Evaluation of the clinical remission duration | At each follow-up (3,6,9 and 12 months after inclusion) |
| Clinical relapse at one year | Evaluation of the probability of a clinical relapse at 1 year based on the ultrasound data | 1 year after inclusion |
| Persistence of ultrasound synovitis (lenght of RA evolution, lenght of clinical remission, anti-CCP, biological inflammatory symptom persistence, treatments) | identifying initial factors that can explain persistence of ultrasound synovitis despite clinical remission | At baseline |
| Radiographic progression at 1 year | Evaluation at joint level the probability of a radiographic progression in presence of a non active synovitis | 1 year after inclusion |
| Intra-observator reproductibility | Evaluating the intra-observer reliability for US synovitis through study completion | 1 year after inclusion |
| D003240 |
| Connective Tissue Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |