Temporal evolution of synovial histopathology in rheumatoid arthritis across treatment periods: a large-scale analysis of 1770 surgical specimens using the Rooney score
Authors' conclusion
RA synovial histopathology evolved across treatment periods, with lower Rooney scores and marked reductions in lymphocytic infiltration.
Study context
- Population
- Patients with rheumatoid arthritis (RA) who underwent orthopaedic surgery between 2011 and 2025 (surgical cohort)1,770 synovial specimens
- Participants
- 1,150 patients
- Exposure
- Synovial histopathology (Rooney score) across treatment periods: early biological disease-modifying antirheumatic drug (bDMARD) vs established bDMARD vs contemporary targeted therapy
- Outcome
- Total Rooney score of synovial histopathology
Methodological detailsmixed-effects models with patient-level random intercepts, sensitivity analyses
- Mixed-effects models with patient-level random intercepts
- Sensitivity analyses
Main finding
As reported in the abstract
Total Rooney score, median (driven by lower lymphocytic infiltration)
- Trend across the periods
- p for trend <0.001
Observational data: associations, not effects.
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Temporal evolution of synovial histopathology in rheumatoid arthritis across treatment periods: a large-scale analysis of 1770 surgical specimens using the Rooney score. RMD Open. Published 23 September 2026. doi:10.
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