{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T16:56:47Z","timestamp":1770224207832,"version":"3.49.0"},"reference-count":17,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,6,5]],"date-time":"2019-06-05T00:00:00Z","timestamp":1559692800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1-TR001866"],"award-info":[{"award-number":["UL1-TR001866"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010303","name":"Melvin A. Block Family Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010303","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["1UH2-AR-067691-01\/11652401"],"award-info":[{"award-number":["1UH2-AR-067691-01\/11652401"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Patients with rheumatoid arthritis (<jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>) in clinical remission may have subclinical synovial inflammation. This study was undertaken to determine the proportion of patients with <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> in remission or with low disease activity at the time of arthroplasty who had histologic or transcriptional evidence of synovitis, and to identify clinical features that distinguished patients as having subclinical synovitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We compared Disease Activity Score in 28 joints (<jats:styled-content style=\"fixed-case\">DAS<\/jats:styled-content>28) to synovial histologic features in 135 patients with <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> undergoing arthroplasty. We also compared <jats:styled-content style=\"fixed-case\">DAS<\/jats:styled-content>28 scores to <jats:styled-content style=\"fixed-case\">RNA<\/jats:styled-content>\u2010Seq data in a subset of 35 patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fourteen percent of patients met <jats:styled-content style=\"fixed-case\">DAS<\/jats:styled-content>28 criteria for clinical remission (<jats:styled-content style=\"fixed-case\">DAS<\/jats:styled-content>28 &lt;2.6), and another 15% met criteria for low disease activity (<jats:styled-content style=\"fixed-case\">DAS<\/jats:styled-content>28 &lt;3.2). Histologic analysis of synovium revealed synovitis in 27% and 31% of samples from patients in remission and patients with low disease activity, respectively. Patients with low disease activity and synovitis also exhibited increased C\u2010reactive protein (<jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>) (<jats:italic>P<\/jats:italic> = 0.0006) and increased anti\u2013cyclic citrullinated peptide (anti\u2010<jats:styled-content style=\"fixed-case\">CCP<\/jats:styled-content>) antibody levels (<jats:italic>P<\/jats:italic> = 0.03) compared to patients without synovitis. Compared to patients with a \u201clow inflammatory synovium\u201d subtype, 183 genes were differentially expressed in the synovium of patients with subclinical synovitis. The majority of these genes (86%) were also differentially expressed in the synovium of patients with clinically active disease (<jats:styled-content style=\"fixed-case\">DAS<\/jats:styled-content>28 \u22653.2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Thirty\u2010one percent of patients with low clinical disease activity exhibited histologic evidence of subclinical synovitis, which was associated with increased <jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content> and anti\u2010<jats:styled-content style=\"fixed-case\">CCP<\/jats:styled-content> levels. Our findings suggest that synovial gene expression signatures of clinical synovitis are present in patients with subclinical synovitis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.40878","type":"journal-article","created":{"date-parts":[[2019,3,5]],"date-time":"2019-03-05T19:00:57Z","timestamp":1551812457000},"page":"1034-1041","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Histologic and Transcriptional Evidence of Subclinical Synovial Inflammation in Patients With Rheumatoid Arthritis in Clinical Remission"],"prefix":"10.1002","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9859-7199","authenticated-orcid":false,"given":"Dana E.","family":"Orange","sequence":"first","affiliation":[{"name":"Hospital for Special Surgery and Rockefeller University  New York New 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York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline S.","family":"Jiang","sequence":"additional","affiliation":[{"name":"Rockefeller University Hospital  New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark P.","family":"Figgie","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery  New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayu O.","family":"Frank","sequence":"additional","affiliation":[{"name":"Rockefeller University  New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4385-704X","authenticated-orcid":false,"given":"William H.","family":"Robinson","sequence":"additional","affiliation":[{"name":"Stanford University, Stanford, California, and VA Palo Alto Health Care System  Palo Alto California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura T.","family":"Donlin","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery  New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Rozo","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery  New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellen M.","family":"Gravallese","sequence":"additional","affiliation":[{"name":"University of Massachusetts Memorial Medical Center  Worcester"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivian P.","family":"Bykerk","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery  New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan M.","family":"Goodman","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery  New York New 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