ASSOCIATION BETWEEN THE 7-JOINT ULTRASOUND SCORE (US7S) AND PHYSICAL FUNCTION IN RHEUMATOID ARTHRITIS

J. Zavada, P. Hanova, J. Hurnakova, M. Uher, L. Puczokova, S. Forejtova, M. Klein, H. Mann, M. Olejarova, O. Sleglova, K. PavelkaInstitute of Rheumatology, Prague Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech RepublicObjectives: To investigate the longitudinal relationship between physical disability and US7S in a prospective cohort of patients with RA. Methods: A cohort of 205 RA pts (49 incident/156 prevalent) (mean±SD age 55±14 years, 47% RF+, 63% ACPA+, DAS28-CRP 3.7±1.5, mHAQ 0.43±0.52, disease duration in incident vs. prevalent pts. 0.9±0.7 vs. 8.1± 8.3 resp.) was followed up longitudinally for 29±9 months. Assessments at baseline and at month 3 and 6, and then every 6 months comprised DAS28-CRP, functional evaluations using the modified Health Assessment Questionnaire (mHAQ) and an ultrasound assessment of the clinically dominant hand and foot by US7S. US7S consists of 5 subscores for synovitis (syn) and tenosynovitis (ten) assessed by grey-scale (GS) and Power-Doppler (PD), and an erosions score (ES). A linear mixed model was used to assess the longitudinal relationship between US7 subscores and mHAQ. Univariate analyses with an interaction term for incident vs. prevalent disease, and a multivariate analysis (with age, sex, BMI, RF and ACPA status, and DAS28-CRP entered as covariates) were performed. Results: In univariate analyses (table) mHAQ was longitudinally associated with GSsyn, PDsyn, PDten and GSten US7 subscores (with resp. β coefficients significantly higher in incident patients), while erosions score was a significant predictor of mHAQ only in prevalent pts. In a multivariate model the US7 subscores were individually no longer significant predictors of mHAQ, although the R of the model was improved by addition of US7 items from 43.6 to 46.9 (p<0.001 for improvement of R). Table 1. Univariate analyses and interaction with incident (i)/prevalent (p) RA (predicted variable – mHAQ) PredictorRAβ (95% CI)p-value*p-value**% variability explained – R DAS28-CRPall0.112 (0.100; 0.123)<0.0010.51044.5 i0.120 (0.093; 0.146)<0.001 p0.110 (0.097; 0.123)<0.001 GSsynUSall0.008 (0.004; 0.011)<0.0010.0383.2 i0.014 (0.007; 0.021)<0.001 p0.006 (0.002; 0.010)0.002 PDsynUSall0.012 (0.008; 0.016)<0.0010.0184.3 i0.021 (0.012; 0.029)<0.001 p0.009 (0.004; 0.014)<0.001 GStenUSall0.018 (0.002; 0.035)0.0320.0781.7 i0.045 (0.011; 0.080)0.010 p0.010 (0.000; 0.020)0.316 PDtenUSall0.024 (0.012; 0.037)<0.0010.0322.0 i0.053 (0.024; 0.083)<0.001 p0.017 (0.010; 0.024)0.013 ESall0.009 (−0.003; 0.021)0.1450.0620.3 i−0.021 (−0.055; 0.013)0.216 p0.013 (0.001; 0.026)0.047 *p-value of significance of given β. **p-value of significance of difference between incident and prevalent RA. Conclusions: This study provides evidence that RA related activity and damage reflected by US7S contribute to impaired physical function in RA, and their impact differs in early and established disease. When combined with conventional clinical parameters, the additional explanatory value of US7 for mHAQ was only minor. References: 1. Backhaus M. et al. Evaluation of a novel 7-joint ultrasound score in daily rheumatologic practice: a pilot project. Arthritis Rheum. 2009 Sep 15;61(9):1194–201 Acknowledgement: This work was supported by the project (Ministry of Health, Czech Republic) for consensual development of research organization 023728, and IGA grant NT12437 Disclosure of Interest: None declared DOI: 10.1136/annrheumdis-2016-eular.3472Citation: Annals of the Rheumatic Diseases, volume 75, supplement 2, year 2016, page 632Session: Diagnostics and imaging procedures (Poster Presentations )