Role of Ultrasound for Evaluating Rheumatoid Arthritis in Remission (SONORE)

The objective of this study is to determine the longitudinal relation between clinical remission and ultrasound (US) remission in Rheumatoid arthritis (RA). At a patient level, US-detected residual synovitis (evaluated both by US grey-scale signals and power Doppler signals) is frequent in patients with RA in clinical remission. Several longitudinal studies reveal an association of US-detected residual synovitis and risk of relapse and radiographic progression, in individual patients and joints, over 1-2 years. However, the longitudinal relation between clinical remission and US remission is not so well-known and it is possible that clinical remission arrive before ultrasound remission. Thus arise the question as to whether the presence of US-detected residual synovitis require to adapt the treatment to ultrasound findings or to simply increase the patient care. The investigator propose to conduct a prospective, bi-center, non randomized study.

The study population will include all RA patient at least 18 years old in clinical remission for less than 6 month. The primary endpoint (ability of US-detected residual synovitis to predict relapse or radiographic progression in individual patients and joints) will be evaluated afer 12 months of follow-up The total follow-up will be 12 months with a follow-up every 3 months. In addition to the standard care, each follow-up will include an ultrasound examination of 40 joints and 8 tendons

Persistence of ultrasound synovitis (lenght of RA evolution, lenght of clinical remission, anti-CCP, biological inflammatory symptom persistence, treatments)

identifying initial factors that can explain persistence of ultrasound synovitis despite clinical remission

Evaluation at joint level the probability of a radiographic progression in presence of a non active synovitis

Inclusion Criteria: Age ≥ 18 years PR fulfilling ARC / EULAR (European League Against Rheumatism) 2010 criteria Patient treated by DMARDs (disease-modifying antirheumatic drug) Patient in confirmed remission for less than 6 months Exclusion Criteria: Patient participating simultaneously in another clinical study with blind treatment Patient participating simultaneously in another clinical study involving decreasing of drug dose Patient in post clinical study exclusion period patients subject to legal protection measures Patient unable to read French Pregnant or breast-feeding women patient treated with Rituximab