According to Professor Paul Emery, Arthritis Research UK Professor of Rheumatology and Head of the Musculoskeletal Division, Leeds Instituteof Molecular Medicine, University of Leeds, UK :
In recent years, the introduction of biological agents and application of the Treat to Target (T2T) approach1 have made clinical remission an achievable goal for many patients with rheumatoid arthritis (RA). Once remission is attained, it is important to maintain absence of disease activity and flare for as long as possible. Available data suggest that up to 50% of patients in clinical remission may experience a disease flare within 2 years2 and that increased power Doppler (PD) ultrasound activity in clinical remission is associated with disease flare,3 along with being predictive of longterm structural damage.4
As such, combining imaging with clinical assessments to monitor RA disease activity may further improve outcomes and help to guide subsequent treatment decisions.
The TURA trial has been designed to assess whether the addition of ultrasound-guided therapy to standard clinical management of RA using T2T principles can further improve outcomes in patients with stable, clinical low disease activity/remission. The primary objective is to determine whether therapy modifications guided by ultrasound findings and DAS28 scores can reduce the level of inflammation assessed by PD ultrasound compared with clinical assessment of DAS28 alone. Other key objectives are to establish whether addition of ultrasound-guided therapy can reduce radiographic progression and improve functional outcomes, and identify predictive factors for sustained remission, absence of structural damage and improvement in functional outcomes. It is hoped that results from the TURA trial will contribute to the development of new and improved disease management principles for RA.
Learn more from Professor Paul Emery at Rheumatology congress EULAR 2012, at the GE Healthcare / Abbott co-sponsored symposium: "Treat to target: What are the benefits of using a targeted ultrasound approach?". Learn more here.
1. S molen JS, et al. Ann Rheum Dis 2010;69:631–7.
2. Molenaar ET, et al. Arthritis Rheum 2004;50:36–42.
3. Saleem B, et al. Ann Rheum Dis 2012; 31 Jan [Epub].
4. Brown AK, et al. Arthritis Rheum 2008;58:2958–67.