ArticleRheumatology (Oxford, England)2021
Ultrasound to identify systemic lupus erythematosus patients with musculoskeletal symptoms who respond best to therapy: the US Evaluation For mUsculoskeletal Lupus longitudinal multicentre study.
Article in Rheumatology (Oxford, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 26 citations in OpenAlex.
- Anifrolumab efficacy and safety by type I interferon gene signature and clinical subgroups in patients with SLE: post hoc analysis of pooled data from two phase III trials.Annals of the rheumatic diseases · 2022Trial
- Musculoskeletal manifestations of systemic lupus erythematosus.Skeletal radiology · 2025Review
- Improving the arthritis component of the SLEDAI-2K.Rheumatology (Oxford, England) · 2025Observational
- ANA-associated arthritis: clinical and biomarker characterization of a population for basket trials.Rheumatology (Oxford, England) · 2024Observational
- Practical Use of Ultrasound in Modern Rheumatology-From A to Z.Life (Basel, Switzerland) · 2024Review
- Clinical trial outcomes for SLE: what we have and what we need.Lupus science & medicine · 2024Review
- Article
- The Utility of Ultrasound in Evaluating Joint Pain in Systemic Lupus Erythematosus: Looking beyond Fibromyalgia.Journal of personalized medicine · 2023Article
- Emerging concepts of type I interferons in SLE pathogenesis and therapy.Nature reviews. Rheumatology · 2022Review
- Update on Current Imaging of Systemic Lupus Erythematous in Adults and Juveniles.Journal of clinical medicine · 2022Review
- A Narrative Literature Review Comparing the Key Features of Musculoskeletal Involvement in Rheumatoid Arthritis and Systemic Lupus Erythematosus.Rheumatology and therapy · 2022Review
- A glimpse into the future of systemic lupus erythematosus.Therapeutic advances in musculoskeletal disease · 2022Review
- Biomarkers Associated with Organ-Specific Involvement in Juvenile Systemic Lupus Erythematosus.International journal of molecular sciences · 2021Review
- Imaging of Joint and Soft Tissue Involvement in Systemic Lupus Erythematosus.Current rheumatology reports · 2021Review
Corrections and comments
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Authors and funding
15 authors at 8 institutions in 2 countries.
Funding
Abstract
objectivesTo determine whether SLE patients with inflammatory joint symptoms and US synovitis/tenosyovitis achieve better clinical responses to glucocorticoids compared with patients with normal scans. Secondary objectives included identification of clinical features predicting US synovitis/tenosynovitis.
methodsIn a longitudinal multicentre study, SLE patients with physician-diagnosed inflammatory joint pain received intramuscular methylprednisolone 120 mg once. Clinical assessments, patient-reported outcomes and bilateral hand/wrist USs were collected at 0, 2 and 6 weeks. The primary outcome (determined via internal pilot) was the early morning stiffness visual analogue scale (EMS-VAS) at 2 weeks, adjusted for baseline, comparing patients with positive (greyscale ≥2 and/or power Doppler ≥1) and negative US. Post hoc analyses excluded FM.
resultsOf 133 patients, 78 had a positive US. Only 53 (68%) of these had one or more swollen joint. Of 66 patients with one or more swollen joint, 20% had a negative US. A positive US was associated with joint swelling, symmetrical small joint distribution and serology. The primary endpoint was not met: in the full analysis set (N = 133) there was no difference in baseline-adjusted EMS-VAS at week 2 [-7.7 mm (95% CI -19.0, 3.5); P = 0.178]. After excluding 32 patients with FM, response was significantly better in patients with a positive US at baseline [baseline-adjusted EMS-VAS at 2 weeks -12.1 mm (95% CI -22.2, -0.1); P = 0.049]. This difference was greater when adjusted for treatment [-12.8 mm (95% CI -22, -3); P = 0.007]. BILAG and SLEDAI responses were higher in US-positive patients.
conclusionIn SLE patients without FM, those with a positive US had a better clinical response to therapy. Imaging-detected synovitis/tenosynovitis may be considered to decide on therapy and enrich clinical trials.
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