Evidence map›Paper›PMID 42028475›Full record

ArticleCureus2026

Musculoskeletal Ultrasound and the Decision to Switch Therapy in Patients With Established Rheumatoid Arthritis.

Vincent Tran, Thanda Aung, Erin Bauer, Holly Wilhalme, Chesca Barrios, Jordan Jacquez, Samantha Duong-Brett, Elizabeth Miller, Ernest Maningding, Benedict Tiong and 7 more

Abstract read
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In one paragraph

Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Vincent TranRheumatology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA.
Thanda AungRheumatology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA.
Erin BauerRheumatology, Virginia Mason Medical Center, Seattle, USA.
Holly WilhalmeStatistics, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA.
Chesca BarriosRheumatology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA.
Jordan JacquezRheumatology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA.
Samantha Duong-BrettRheumatology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA.
Elizabeth MillerRheumatology, Park Nicollet Clinic and Specialty Center, St. Louis Park, USA.
Ernest ManingdingRheumatology, Alameda Health System, Oakland, USA.
Benedict TiongRheumatology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA.
Ruta TesfamicaelRheumatology, Catalina Pointe Arthritis and Rheumatology Clinic, Tucson, USA.
Tracy DriverRheumatology, Optum Health, Anaheim, USA.
Gihyun MyungRheumatology, Seoul National University, Seoul, KOR.
Chen XieRheumatology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA.
Lisa ZhuRheumatology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA.
David ElashoffStatistics, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA.
Veena K RanganathRheumatology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction  Musculoskeletal ultrasound (MSUS) with power Doppler ultrasound (PDUS) or gray-scale ultrasound (GSUS) has been increasingly used to detect active synovitis. This study evaluated PDUS/GSUS scores and clinical disease activity scores in patients with established rheumatoid arthritis (RA) whose rheumatologist was considering a therapy switch. Methods  Thirty-two patients with RA were enrolled. Clinical Disease Activity Index (CDAI), Disease Activity Score-28 (DAS28), and PDUS/GSUS scores were obtained. Pearson correlation coefficients were used to evaluate the relationship of PDUS-24 and GSUS-24 with clinical composite measures. Demographics, disease activity measures, MSUS scores, and patient-reported outcomes were examined between switchers and non-switchers. Results  Of the 32 patients enrolled, 59% (n=19) switched therapy. Switchers had numerically higher DAS28, CDAI, CRP/ESR, and PDUS/GSUS scores, but these metrics were not statistically significantly different from those of non-switchers. Among patients with concordant findings, 80% (n=8/10) of those with DAS28 ≥3.2 and high PDUS (>5) switched therapy, whereas only 25% (n=1/4) of patients with DAS28 <3.2 and low PDUS (≤5) did so. In the discordant group, therapy was switched in 60% of patients with high DAS28/low PDUS (n=6/10) and 60% of those with low DAS28/high PDUS (n=3/5). Physician global assessment and physician-reported RA flare were higher among therapy switchers (t(29) = -2.96, p=0.006; and Fisher's exact p=0.03, respectively). Non-switchers were more satisfied with their treatment compared to switchers (8.8 vs 5.3, t(30) = 4.42, p<0.001). Conclusion  Among patients with established RA, disease-modifying antirheumatic drug (DMARD) switchers had numerically higher CDAI, DAS28, and PDUS/GSUS scores compared with non-switchers. Eighty percent of patients with both increased DAS28 and PDUS switched therapy, compared with 60% of those with discordant findings, including high DAS28/low PDUS and vice versa. The PDUS/DAS28-discordant population faces inherently difficult therapeutic decisions and highlights the lack of guidance for physicians and patients.

Indexed as

disease modifying agentflare upmusculoskeletal ultrasoundrheumatoid arthritisswitching therapy

Identifiers

PMID42028475
PMCPMC13102373

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.