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The following is a summary of “Baseline synovitis-tenosynovitis associates with remission in early rheumatoid arthritis but discordance with disease activity is a changeable state,” published in the February 2025 issue of Rheumatology by Shukla et al. 

Researchers conducted a retrospective study to assess the link between baseline joint-complex inflammation ([power Doppler-detected joint synovitis (PDUS) and/or tenosynovitis (PDTS)] and remission in new-onset, treatment-naïve rheumatoid arthritis (RA). The study also examined the dynamic discordance and concordance between clinical disease activity and PD ultrasound. 

They categorized treatment-naïve early patients with RA from a randomized controlled trial at baseline according to dominant hand PDUS and/or PDTS presence into 4 groups: PDUS+PDTS+, PDUS+PDTS-, PDUS-PDTS+, and PDUS-PDTS-. Longitudinally, patients were grouped based on clinical disease activity state (DAS) and PDUS presence into: DAS+PDUS+ (DAS28-ESR > 2.6, PDUS > 0), DAS+PDUS- (DAS28-ESR > 2.6, PDUS = 0), DAS-PDUS+ (DAS28-ESR ≤ 2.6, PDUS > 0), and DAS-PDUS- (DAS28-ESR ≤ 2.6, PDUS = 0). Bayesian logistic regression analysis was applied. 

The results showed baseline PDUS+PDTS+ was associated with week 24 remission (posterior estimate = 1.41, credible interval = 0.16–2.65). At baseline, 68% were DAS+PDUS+ and 32% DAS+PDUS-. Early transition from DAS+PDUS+ to DAS+PDUS- occurred in 32% at week 12. DAS+PDUS- remained at 43% at week 24, with 41% of baseline DAS+PDUS- patients remaining in this group through week 48. 

Investigators found that in new-onset RA, baseline joint-complex PD is associated with week 24 remission. DAS+PDUS- emerged early but, like DAS+PDUS+ and DAS-PDUS-, was a dynamic state, highlighting opportunities for therapeutic targeting. 

Source: academic.oup.com/rheumatology/advance-article/doi/10.1093/rheumatology/keaf098/8019684