{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T23:03:36Z","timestamp":1774739016732,"version":"3.50.1"},"reference-count":44,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T00:00:00Z","timestamp":1611532800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aimed to investigate the predictive value of synovitis and tenosynovitis detected by grayscale (GS) and by power Doppler (PD) ultrasound (US) in relation to failure of tapering disease\u2010modifying antirheumatic drugs (DMARD) in rheumatoid arthritis (RA) patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Long\u2010standing RA patients who de\u2010escalated treatment were included in this prospective cohort study. All patients underwent 3 ultrasonographic and clinical assessments, at baseline and every 3 or 4\u2009months, over a period of 6\u20138\u2009months. US investigation of 32 joints was performed. Synovitis was assessed by GS and PD semiquantitative scoring (0\u20133) and a global score was calculated for each individual by summing single joint scores. The presence of tenosynovitis was recorded whenever detected during ultrasound assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010three patients completed the follow\u2010up period (29 women; 4 men). Eight patients (25%) relapsed. Using the optimal cutoff values determined by receiver operating characteristic curve, patients with a PD synovitis \u22651 at baseline had significantly greater chances to relapse than those without PD activity. During follow\u2010up, GS tenosynovitis was detected in 6 patients (5 with PD) who failed and in 3 patients (1 with PD) who succeeded in tapering therapy. Having at least 1 joint with PD synovitis resulted in a relative risk of 3.14 and having GS tenosynovitis resulted in a relative risk of 11.4 (95% CI: 1.03\u20139.60 and 2.82\u201345.9, respectively) for relapse in the multivariate Poisson model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>PD synovitis and GS tenosynovitis may be useful to identify RA patients in risk of relapse after DMARD tapering.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jum.15640","type":"journal-article","created":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T20:55:41Z","timestamp":1611608141000},"page":"2549-2559","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Synovitis and Tenosynovitis on Ultrasound as Predictors of <scp>DMARD<\/scp> Tapering Failure in Patients with Long\u2010Standing Rheumatoid Arthritis in Clinical Remission or Low Disease Activity"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6005-4612","authenticated-orcid":false,"given":"\u00c2ngela","family":"Massignan","sequence":"first","affiliation":[{"name":"Programa de P\u00f3s\u2010Gradua\u00e7\u00e3o em Ci\u00eancias M\u00e9dicas, Faculdade de Medicina Universidade Federal do Rio Grande do Sul  Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael","family":"Mendon\u00e7a da Silva Chakr","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Reumatologia, Hospital de Cl\u00ednicas de Porto Alegre, Universidade Federal do Rio Grande do Sul  Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Pamplona Bueno de Andrade","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Reumatologia, Hospital de Cl\u00ednicas de Porto Alegre, Universidade Federal do Rio Grande do Sul  Porto 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