SAT0404 Active synovitis in clinical sustained remission: A cross sectional ultrasound study of rheumatoid arthritis patients treated with traditional and biological dmards

Background Some rheumatoid arthritis (RA) patients considered in clinical remission undergo structural and functional worsening, due to residual subclinical inflammation 1. However, it is unknown if traditional DMARDs and biological agents present different efficacy in inducing complete suppression of inflammation as determined by ultrasound (US). Objectives To determine the prevalence of ultrasound (US) detected synovitis in RA patients presenting a clinical sustained remission treated with traditional DMARDs or biological agents, and compare the US findings of both groups of treatment. Methods Seventy-seven RA patients (ACR1987 and ACR/EULAR 2010 criteria), in regular follow-up at the Rheumatology Departments of Universita Politecnica delle Marche (Italy) and Universidade de Sao Paulo (Brazil), considered in clinical sustained remission (DAS 28 criteria 5=7%) with greyscale synovial hypertrophy. Futhermore, 44% of all patients presented increased PD sign in at least one (50%) or more (2-5=47%, >5=3%) joints. Eleven patients from the 24 under biological therapy, and 23 patients from the 53 under DMARDs presented PD sign in at least one joint, with no significant difference among both groups (p=0.8). Conclusions Our study demonstrates that a high number of RA patients under DMARDs and biological agents considered in clinical remission presented active synovitis detected by US. This finding strengthens the importance of imagi