Targeting Synovitis in Early Rheumatoid Arthritis

Launched by NHS GREATER GLASGOW AND CLYDE · Jun 11, 2009

Keywords

ClinConnect Summary

PURPOSE 1 - to determine whether it is possible to achieve better control of inflammatory joint disease activity in early rheumatoid arthritis by using musculoskeletal ultrasound, instead of clinical examination, to identify the presence, or absence, of synovitis

NULL HYPOTHESIS 1 - using musculoskeletal ultrasound to confirm / refute the presence of ongoing synovitis will NOT allow better control of early rheumatoid arthritis nor prevent progression of destructive joint disease despite patients receiving more intensive disease modifying therapy regimens

PURPOSE 2 - to determine whether b...

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Eligibility criteria

• Inclusion Criteria:
• • 1. Patients attending Early RA clinics with newly diagnosed RA or anti-CCP +ve Undifferentiated Arthritis (UA)
• • 2. Active disease (DAS28 \> 3.2)
• • 3. DMARD naïve or DMARD monotherapy for less than 6 weeks
• • 4. Aged 18 or more
• Exclusion Criteria:
• • 1. Significant liver disease and/or abnormality of liver function tests
• • 2. AST / ALT \> x2 normal, Alkaline Phosphatase \> x2.5 normal
• • 3. Renal impairment - serum creatinine \> 200 μmol/l, eGFR \< 30
• • 4. Cytopenias - white cell count \< 4.0, haemoglobin \< 10, platelet \< 150
• • 5. Pregnancy or planned pregnancy
• • 6. Contraindication to MRI
• • 7. Other co-morbid condition that in the opinion of the investigator would preclude the use of sequential or combination DMARD therapy