Ultrasound-defined presynovitis is associated with progression to clinical arthritis in anticitrullinated protein antibody (ACPA)-positive individuals at risk of rheumatoid arthritis: longitudinal insights from the Karolinska Risk-RA cohort
Main finding · Clinical arthritis, any US finding at baselineResult — go to the resultHazard ratio 3.3 95% CI 2.3–4.8Authors' conclusion
Minimal US findings preceding Doppler-active synovitis, particularly tendon involvement, were strongly associated with progression to clinical arthritis in ACPA-positive individuals and support an US-identified 'presynovitis' phase of rheumatoid arthritis development and early risk stratification.
Study context
- Population
- ACPA-positive individuals with musculoskeletal (MSK) symptoms but without clinical arthritis and Doppler-active synovitismedian follow-up 13 months (IQR 7–22)
- Participants
- 309 individuals
- Exposure
- Any ultrasound (US) finding at baseline vs no US finding
- Any US findingn = 75
- Outcome
- Development of clinical arthritis
- Follow-up
- 3 years
Methodological detailsCox regression and logistic regression models, longitudinal within-individual US trajectories
- Cox regression and logistic regression models
- Longitudinal within-individual US trajectories
Main finding
Clinical arthritis, any US finding at baseline
Hazard ratio
3.3
95% CI 2.3–4.8
As reported in the abstract
- Developed clinical arthritis (all participants)
- 117 of 309 (38%)
Observational data: associations, not effects.
Further findings
Clinical arthritis, tendon sheath involvement
| HR (95% CI) | ||
|---|---|---|
| Tendon sheath involvement | 3.6 (2.4–5.4) | |
| 0.20.5125Hazard ratio (log scale) |
Clinical arthritis, tendon sheath involvement with IgM RF positivity
| HR (95% CI) | ||
|---|---|---|
| Tendon sheath involvement + IgM RF positivity | 4.2 (2.7–6.4) | |
| 0.10.31310Hazard ratio (log scale) |
Progressors fulfilling 2010 ACR/EULAR RA classification criteria
- Fulfilled 2010 ACR/EULAR RA criteria
- 97 of 117 (83%)
Longitudinal US trajectories
- Progressive accumulation of US findings prior to arthritis onset; findings remained infrequent among nonprogressors
- Tendon involvement frequently preceded synovial changes
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →