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Randomized Controlled Trial
. 2024 Dec 31;10(4):e005002.
doi: 10.1136/rmdopen-2024-005002.

Synovitis scoring in hand osteoarthritis with ultrasonography: the performance of the Global OMERACT/EULAR Ultrasound Synovitis Score (GLOESS) is comparable to synovial thickening alone

Coen van der Meulen  1 , Marion C Kortekaas  2   3 , Maria Antonietta D'Agostino  4 , Féline P B Kroon  5   6 , Frits R Rosendaal  7 , Margreet Kloppenburg  5
Affiliations
Randomized Controlled Trial

Synovitis scoring in hand osteoarthritis with ultrasonography: the performance of the Global OMERACT/EULAR Ultrasound Synovitis Score (GLOESS) is comparable to synovial thickening alone

Coen van der Meulen et al. RMD Open. .

Abstract

Background: Inflammation is increasingly recognised as a treatment target in hand osteoarthritis, and therefore correct measurement of local inflammation is essential. This study aimed to assess ultrasound scoring of synovitis and the additional value of the Global OMERACT/EULAR Ultrasound Synovitis Score (GLOESS) in hand osteoarthritis.

Methods: Data from the randomised, double-blinded Hand Osteoarthritis Prednisolone Efficacy (HOPE) trial were used. The HOPE trial included patients with painful, inflammatory hand OA, treated with prednisolone or placebo (1:1). Ultrasound was performed in 30 hand joints at weeks 0, 6 and 14. Effusion, synovial thickening and Doppler signal were measured, the GLOESS was calculated from the latter two. Joint tenderness on palpation was assessed semiquantitatively (0-3), soft swelling as present/absent. Changes in ultrasound scores, and their association with change in joint tenderness or soft swelling, were investigated using generalised estimating equations. Effect sizes were calculated.

Results: Of 92 included patients 79% were women, with mean (SD) age 63.9 (8.8) and body mass index 27.2 (4.6). Synovial thickening was the most prevalent. All ultrasound scores were strongly associated with joint tenderness and soft swelling cross-sectionally. There was no association of change in ultrasound scores with change in tenderness, but there was with change in soft tissue swelling. Synovial thickening and the GLOESS responded to treatment (effect size -0.39 (-0.72 to -0.07), -0.39 (-0.71 to -0.07), respectively).

Discussion: Various ultrasound scores were associated with joint tenderness and soft swelling. The GLOESS and synovial thickening were both responsive to treatment, but GLOESS was not superior to synovial thickening alone.

Keywords: osteoarthritis; synovitis; ultrasonography.

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Conflict of interest statement

Competing interests: MK reports the following, all outside the current study. Grant from IMI-APPROACH. Royalties or licences from Wolters Kluwer and Springer Verlag, paid to the institution. Fees for consulting/advisory boards by Pfizer, UCB, CHDR, GSK, Novartis and Peptinov, all paid to the institution. Payment or honoraria for lectures or presentations from Novartis, paid to the institution. Roles on the OARSI board (member), EULAR council (member advocacy committee EULAR) and presidency of the Dutch Society for Rheumatology. For the current study, MK reports funding from the Dutch Arthritis Society, paid to the institution. The other authors report no competing interests.

Figures

Figure 1
Figure 1. Changes in ultrasound scores over time. Changes of effusion, synovial thickening, Doppler and GLOESS sum scores over 14 weeks of follow-up. Yellow lines indicate placebo group, blue lines indicate prednisolone group. Data are shown as mean±SE. Some data in the figure were previously published in the original analysis of the Hand Osteoarthritis Prednisolone Efficacy trial. GLOESS, Global OMERACT/EULAR Ultrasound Synovitis Score.
See this image and copyright information in PMC

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