Ultrasound in anti-CCP+ at-risk individuals without clinical synovitis: development of a novel 6-joint protocol for feasible risk prediction
Main finding · Prediction of inflammatory arthritis development (AUC)Result — go to the resultDifference in Akaike information criteria <2Authors' conclusion
US provides valuable information for predicting progression to inflammatory arthritis in CCP+ individuals both alone and in addition to clinical variables. US synovitis was associated with a 3-fold increase risk of inflammatory arthritis development. A concise US protocol of six joints provides clinically feasible risk prediction in CCP+ at-risk.
Study context
- Population
- Anti-CCP+ individuals with musculoskeletal symptoms but no clinical synovitis (Leeds CCP cohort), baseline US of 36 joints, follow-up ≥24 monthsLeeds CCP cohort
- Participants
- 417 individuals
- Exposure
- Clinical model vs clinical-US extended (36-joint) model vs clinical-US short (6-joint) model for predicting inflammatory arthritis
- Outcome
- Inflammatory arthritis development
- Follow-up
- 24 months
Methodological detailsprognostic model development, multivariable binary regression
- Prognostic model development
- Multivariable binary regression
Main finding
As reported in the abstract
Difference in Akaike information criteria
<2
By group
clinical-US extended
0.788
AUC
Clinical
0.731
AUC
clinical-US short
0.782
AUC
Observational data: associations, not effects.
Further findings
Inflammatory arthritis incidence (all CCP+ at-risk) · 24 months
- Developed inflammatory arthritis
- 92/417 (22.1%)
- Time to inflammatory arthritis, median (IQR 3-12)
- 7 months
Predictors of inflammatory arthritis in clinical-US extended model · 24 months
- US synovitis, OR
- 3.18 (95% CI 1.80-5.63)
- Bone erosions, OR
- 2.54 (95% CI 1.21-5.37)
Original publication
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