Factors associated with resolution of ultrasound subclinical synovitis in anti-CCP-positive individuals with musculoskeletal symptoms: a UK prospective cohort study
Authors' conclusion
In individuals who were anti-CCP-positive, subclinical synovitis disappeared in approximately half of the participants by 12 months and was associated with the presence of good prognostic factors.
Study context
- Population
- Anti-CCP-positive individuals aged ≥18 years with a new non-specific musculoskeletal symptom, no clinical synovitis, and US subclinical synovitis (grey scale ≥1 and power Doppler ≥1) in ≥1 joint at baseline, UK90 with 12-month data
- Participants
- 122 individuals
- Outcome
- Resolution of subclinical synovitis and its predictors (good prognostic factors)
- Follow-up
- 12 months
Methodological detailssingle-centre, modified Poisson regression, missing values imputed, Between June 30, 2008, and Feb 24, 2020; 451 consented to the CCP study
- Single-centre
- Modified Poisson regression
- Missing values imputed
- Between June 30, 2008, and Feb 24, 2020; 451 consented to the CCP study
Main finding
As reported in the abstract
Resolution of subclinical synovitis
- Subclinical synovitis resolved
- 43 (48%) of 90
- Subclinical synovitis persisted
- 47 (52%)
- Predictor: low anti-CCP titre, RR
- 1.52, 1.04-2.22 (95% CI)
- Predictor: negative RF, RR
- 1.54, 0.92-2.58 (95% CI)
- Predictor: subclinical synovitis in only one joint, RR
- 1.62, 1.04-2.50 (95% CI)
- Predictor: ESR ≤15 mm/h, RR
- 1.82, 1.15-2.87 (95% CI)
- Prediction model AUC
- 0.84 (0.76-0.92; p<0.0001) (95% CI; p)
Observational data: associations, not effects.
Further findings
Progression to clinical synovitis among those with persistent subclinical synovitis · 12 months
- Developed clinical synovitis
- 27 (57%)
Resolution by number of good prognostic factors present · 12 months
- All four factors present
- seven (100%) of seven
- None of the factors present
- one (7%) of 14
Original publication
Factors associated with resolution of ultrasound subclinical synovitis in anti-CCP-positive individuals with musculoskeletal symptoms: a UK prospective cohort study. Lancet Rheumatol. Published February 2024. doi:10.
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