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Ultrasound, clinical parameter agreement observed in patients with psoriatic arthritis
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High levels of ultrasound-verified inflammation or damage were found to be correlated with Evaluator’s Global Assessment and VAS for pain scores in patients with psoriatic arthritis, according to study findings.
A prospective study of 83 patients with psoriatic arthritis was conducted at the Medical University Graz in Graz, Austria. Patients were assessed for tender joint (TJC) and swollen joint (SJC) counts, the Psoriasis Area Severity Index (PASI), dactylitis scores and the Leeds Enthesitis Score. The Patient’s Global Assessment (PGA) and Evaluator’s Global Assessment (EGA), patients’ pain assessment (VAS for pain), the Dermatology Life Quality Index (DLQI) and the Health Assessment Questionnaire (HAQ) were administered. An independent investigator blinded to patient results performed ultrasound with an EASAOTE MyLab Twice ultrasound 6 MHz to 18 MHz device with 3 MHz to 13 MHz probes. Erosions, osteophytes and inflammatory changes were investigated with gray scale (GS) and power Doppler (PD) signals in 68 joints and 14 entheses.
PGA and EGA scores were not in agreement in 65% of the patients. In 53% of patients, EGA scores were lower than PGA scores, and 12% had higher EGA scores. However, a strong correlation was observed between a PD score greater than 10 and EGA and VAS for pain. A strong correlation was seen between patients with high erosion scores and EGA and VAS for pain, whereas in patients with low structural damage, a weak association was seen. The degree of inflammation or damage verified by ultrasound showed no association between PGA and EGA.
Multivariate regression modelling revealed that half of the variability of PGA results may be attributed to VAS for pain, SJC and TJC, according to the researchers, and VAS for pain and HAQ were predictive of PGA.
Variability in EGA results may have been related to the SJC, which was also predictive of EGA, and about half of the PGA variability may be attributable to VAS for pain and GS in joints, the researchers wrote. Results of EGA were associated with GS in joints, the HAQ score, VAS for pain and the PD signal in joints. – by Shirley Pulawski
Reference:
Lackner A, et al. Paper #SAT0331. Presented at: European League Against Rheumatism Annual European Congress of Rheumatology; June 10-13, 2015; Rome.
Disclosure: The researchers report no relevant financial disclosures.