{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:33:07Z","timestamp":1791329587411,"version":"4.3.1"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arthritis Res Ther"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Subclinical synovitis by ultrasound is a frequent finding in rheumatoid arthritis (RA) patients in remission and has been shown to be related to erosive progression, risk of flare and unsuccessful drug tapering, but it has not been investigated how a DAS28 T2T-steered strategy in routine care affects the presence of subclinical synovitis in RA patients in remission. The aim of the current study was to investigate the presence of ultrasound-detected subclinical inflammation in RA patients in long-term remission receiving either biological or conventional disease-modifying anti-rheumatic drugs (bDMARD\/csDMARD) and, finally, to investigate the presence of ultrasound remission using different ultrasound remission criteria.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Eighty-seven RA patients (42 patients receiving bDMARD and 45 csDMARD) received DAS28-CRP-steered treatment in routine care and had achieved DAS28-CRP-remission for <jats:underline>&gt;<\/jats:underline>\u20091\u2009year without radiographic progression. Twenty-four joints were scored 0\u20133 by ultrasound (elbows, wrists, knees, ankles, metacarpophalangeal and metatarsophalangeal joints 2\u20135) for grey-scale synovial hypertrophy (GS) and colour Doppler activity (CD) using the OMERACT scoring system. Ultrasound remission was defined as strict (GS score\u2009=\u20090 and CD score\u2009=\u20090), semi-strict (GS score\u00a0<jats:underline>&lt;<\/jats:underline>\u00a01 and Doppler score\u2009=\u20090) and Doppler remission (Doppler score\u2009=\u20090).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>No differences between treatment groups were found for GS sum score and Doppler sum score (median (range) 6 (0\u201319) and 0 (0\u201312), respectively). A Doppler score\u2009&gt;\u20090 in at least 1 joint was seen in 44%, a GS score\u00a0<jats:underline>&gt;<\/jats:underline>\u00a01 in at least 1 joint in 93% and a GS score\u00a0<jats:underline>&gt;<\/jats:underline>\u00a02 in at least 1 joint in 54% of patients. Strict ultrasound remission was only observed in bDMARD patients (7%; <jats:italic>p<\/jats:italic>\u00a0=\u20090.01). Thirty-seven per cent were in semi-strict ultrasound remission and 56% in Doppler remission (no significant difference between groups) with similar results across the subgroups of patients who also fulfilled the ACR-EULAR Boolean-, CDAI- and SDAI-remission criteria.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Ultrasound frequently detected subclinical synovitis in RA patients in longstanding DAS28-remission obtained through a DAS28-CRP-steered strategy. This was independent of treatment and applied ultrasound remission criteria. Strict ultrasound remission was rare.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13075-021-02426-w","type":"journal-article","created":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T07:02:44Z","timestamp":1612162964000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Using a DAS28-CRP-steered treat-to-target strategy does not eliminate subclinical inflammation as assessed by ultrasonography in rheumatoid arthritis patients in longstanding clinical remission"],"prefix":"10.1186","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8193-9471","authenticated-orcid":false,"given":"Lene","family":"Terslev","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilie Heegaard","family":"Brahe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikkel","family":"\u00d8stergaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktoria","family":"Fana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mads","family":"Ammitzb\u00f8ll-Danielsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torsten","family":"M\u00f8ller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Krabbe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merete Lund","family":"Hetland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uffe M\u00f8ller","family":"D\u00f8hn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,1]]},"reference":[{"issue":"4","key":"2426_CR1","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1136\/ard.2009.123919","volume":"69","author":"JS Smolen","year":"2010","unstructured":"Smolen JS, Aletaha D, Bijlsma JW, Breedveld FC, Boumpas D, Burmester G, et al. 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Despite this, we ensured that all patients gave written informed consent to participate and the study was conducted in accordance with the Declaration of Helsinki.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"No relevant","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Lene Terslev: speaker fee from AbbVie, Janssen, Roche, Novartis, Pfizer, MSD, BMS and GECecilie Heegaard Brahe: noneMikkel \u00d8stergaard: research support, consultancy fees and\/or speaker fees form Abbvie, BMS, Boehringer-Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Novo, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi and UCBViktoria Fana: noneMads Ammitzb\u00f8ll Danielsen: noneTorsten M\u00f8ller: noneSimon Krabbe: research support from AbbVie, MSD and NovartisMerete L Hetland: grants from Bristol-Myers Squibb, AbbVie, Roche and Novartis; grants and personal fees from MSD, Biogen and Pfizer; and personal fees from Eli Lilly, Orion Pharma, CellTrion, Samsung Bioepis and Janssen Biologics B.V.Uffe M\u00f8ller D\u00f8hn: consultancy fees from Eli Lilly, Roche and Novartis; speaker fee from Roche, Novartis","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"48"}}