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Objectives: Remission is the ultimate purpose of treatment in Rheumatoid Arthritis (RA). However, even when the most stringent composite scores were used, structural damages can occur. For that purpose ultrasonography (US) appears to be the best way to assess real remission. Our principal aim was to investigate the validity of different RA remission scores using the US as the reference. Methods: An analytic diagnostic study of 30 RA patients in remission according to DAS28 and a control group with active RA was conducted between January and October of 2018. Among them, we identified patients in remission according to the SDAI, the CDAI, and the ACR/EULAR remission score. The validity of each activity score for remission was calculated using as a gold standard the absence of PD signal. Results: All patients were in remission according to DAS28 with an average score of 2.03 [1.13-2.6]. US examination showed PD signals in 57% of all patients. Twenty-six patients were in remission according to CDAI, a Doppler signal was detected in 58% of those cases. SDAI remission was accomplished in 19 patients with PD activity in 53% of cases. For the 14 patients in remission according to ACR/EULAR criteria, synovial hyper-vascularization was found in 64%. Considering true remission as the absence of PD signals, the most sensitive and specific score was DAS28 (93% and 68% respectively). Conclusion: Considering remission in RA as the absence of vascularized synovitis, the DAS28 was the most sensitive and the most specific score.
Keywords: Rheumatoid Arthritis, remission, ultrasonography, validity
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