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. 2023 Mar;26(1):39-47.
doi: 10.1007/s40477-022-00749-1. Epub 2023 Jan 12.

Correlation between ultrasonographic scores and American college of rheumatology recommended rheumatoid arthritis disease activity measures: a systematic review and network meta-analysis

Jianing Zhu #  1   2 , Jing Wang #  1   2 , Yiping Dong #  1   2 , Yue Song  1   2 , Pintong Huang  3   4
Affiliations

Correlation between ultrasonographic scores and American college of rheumatology recommended rheumatoid arthritis disease activity measures: a systematic review and network meta-analysis

Jianing Zhu et al. J Ultrasound. 2023 Mar.

Abstract

Background: To validate and facilitate ultrasound examinations on rheumatoid arthritis (RA) disease activity measurements in routine clinical practice.

Methods: A systematic review and network meta-analysis (NMA) of ultrasound examinations on joints and its correlation with clinical RA disease activity was performed. PubMed, Embase and Cochrane library were searched for literatures published up to May 01st 2021. Bayesian random-effect NMA was conducted to pool the correlations of ultrasonographic assessment scores with composite RA disease activity measurements.

Results: Fifteen studies evaluating twelve different existing ultrasonographic measurements on joints evaluation for RA disease activity scoring were included in this NMA. For comparisons with clinical disease activity index and simplified disease activity index, synovitis gray scale ultrasound 7 joints (GSUS7) demonstrated modest correlation of 0.30[- 0.74, 1.23] and 0.46[- 0.45, 1.15] respectively, followed by synovitis power Doppler ultrasound 7 joints (PDUS7) (0.25[- 0.57, 1.14], 0.31[- 0.46, 1.24]) and power Doppler ultrasound 12 joints (PDUS12) (0.23[- 1.36, 0.83], 0.25[- 1.18, 0.88]). As for disease activity score using 28 joint counts, PDUS12 showed the biggest correlation of 0.53[- 0.09, 1.11], followed by ultrasound 7 joints (US7) (0.50[0.06, 0.93]), PDUS7 (0.49[- 0.24, 1.12]), power Doppler ultrasound 6 joints (PDUS6) (0.42[- 0.29, 1.21]), synovitis PDUS7 (0.47[- 0.09, 1.27]) and synovitis GSUS7 (0.40[0.01, 0.86]).

Conclusion: Comparative validity was observed on fewer joints ultrasonic evaluation for RA disease activity measurements, such as synovitis GSUS7 and synovitis PDUS7. Ultrasonographic measurements can be complementary for clinical RA disease activity measures with clinical efficiency, and technical guidelines were in need for clinical routine practice.

Keywords: Disease activity; Network meta-analysis; Rheumatoid arthritis; Ultrasonography.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flow diagram of study selection
Fig. 2
Fig. 2
Network graph for NMA, including A DAS28, and B CDAI & SDAI. The nodes are connected by a line if there is at least one study comparing the two ultrasonographic scores, and thickness of the line is proportional to the number of studies comparing the two ultrasonographic scores, with the size of the node reflecting the number of participants
Fig. 3
Fig. 3
Correlation of ultrasonographic scores with RA disease activity measures by forest plots, including A DAS28, B CDAI, and C SDAI
See this image and copyright information in PMC

References

    1. Johnson TM, Register KA, Schmidt CM, O'Dell JR, Mikuls TR, Michaud K, et al. Correlation of the multi-biomarker disease activity score with rheumatoid arthritis disease activity measures: a systematic review and meta-analysis. Arthritis Care Res (Hoboken) 2019;71:1459–1472. doi: 10.1002/acr.23785. - DOI - PMC - PubMed
    1. Smolen JS, Aletaha D, Barton A, Burmester GR, Emery P, Firestein GS, et al. Rheumatoid arthritis. Nat Rev Dis Primers. 2018;4:18001. doi: 10.1038/nrdp.2018.1. - DOI - PubMed
    1. Santos-Moreno P, Villarreal Peralta L, Cabrera M, Alvis-Zakzuk NJ, Buitrago-Garcia D. Conventional versus biological treatment for ankylosing spondylitis. results from a real-life setting. Value Health Region Issues. 2019;19:S52–S53.
    1. Backhaus M, Burmester G-R, Gerber T, Grassi W, Machold KP, Swen WA, et al. Guidelines for musculoskeletal ultrasound in rheumatology. Ann Rheum Dis. 2001;60:641–649. doi: 10.1136/ard.60.7.641. - DOI - PMC - PubMed
    1. Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015;350:g7647. doi: 10.1136/bmj.g7647. - DOI - PubMed

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