| Title: |
Ultrasound-Guided Synovial Biopsy Can Be Effectively and Safely Performed in Different Clinical Settings Favouring a Widespread Application of Precision Medicine in Rheumatoid Arthritis: A Post-hoc Analysis of Three Clinical Trials |
| Authors: |
Mattia Congia; Stefano Marini; Alessandra Nerviani; Felice Rivellese; Georgina Thorborn; Rebecca Hands; Maria Maddalena Angioni; Elisabetta Chessa; Alberto Floris; Piero Mascia; Matteo Piga; Frances Humby; Stefano Marcia; Costantino Pitzalis; Alberto Cauli |
| Source: |
Journal of Clinical Medicine ; Volume 15 ; Issue 6 ; Pages: 2233 |
| Publisher Information: |
Multidisciplinary Digital Publishing Institute |
| Publication Year: |
2026 |
| Collection: |
MDPI Open Access Publishing |
| Subject Terms: |
rheumatoid arthritis; synovial biopsy; precision medicine |
| Description: |
Objectives: In the perspective of an increasingly widespread application of precision medicine in rheumatoid arthritis (RA), this study aimed to compare efficacy and safety of ultrasound-guided synovial biopsy (US-SB) performed in an experienced rheumatology and community hospital setting. Methods: A post hoc analysis of R4RA, STRAP and STRAP-EU trials was performed, comparing US-SB performed in a radiology department of a community hospital without experience in RA (n = 14), versus a rheumatology academic centre with a high expertise in RA management and US-SB (n = 16). Suitability of specimens for histological and transcriptomic analysis (tissue and RNA quality) was analyzed as the main outcome. Results: Demographic and clinical features of the two patients’ groups were similar, except of disease duration (p < 0.05). No differences were recorded regarding site and ultrasound of the biopsied joint. Suitability for histological (% of gradable tissue) and transcriptomic analysis (RIN >3) was similar in the two cohorts (both 85.7% vs. 87.5%, p = 0.88). Proportion of gradable biopsies in total (59.2% vs. 59.5%, p = 0.96) and for each patient (52% vs. 56.15%, p = 0.77), were similar in both cohorts. Adverse events were rare (two in community hospital cohort, one in rheumatology cohort, p = 0.54), none considered severe. Seven patients in the community hospital experienced mild or severe pain, only two referred the same in the rheumatology cohort (p = 0.04). Conclusions: US-SB can be safely and effectively performed in a community hospital without experience in RA. A larger diffusion of this technique could allow to pursuit a tailored approach also in ordinary rheumatology outpatient clinics. |
| Document Type: |
text |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
Immunology & Rheumatology; https://dx.doi.org/10.3390/jcm15062233 |
| DOI: |
10.3390/jcm15062233 |
| Availability: |
https://doi.org/10.3390/jcm15062233 |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.1C607D6A |
| Database: |
BASE |