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Trial registered on ANZCTR
Registration number
ACTRN12610000284066
Ethics application status
Approved
Date submitted
3/04/2010
Date registered
8/04/2010
Date last updated
26/08/2024
Date data sharing statement initially provided
26/08/2024
Date results provided
26/08/2024
Type of registration
Retrospectively registered
Titles & IDs
Public title
A longitudinal study of patients with rheumatoid arthritis starting biological therapy; Assessment of joint inflammation by use of ultrasonography
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Scientific title
ULRABIT: ULtrasonography of Rheumatoid Arthritis (RA) patients starting BIological Treatment: A longitudinal study assessing joint inflammation
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Secondary ID [1]
1572
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None
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Universal Trial Number (UTN)
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Trial acronym
ULRABIT
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Arthritis in patients with rheumatoid arthritis
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Synovitis and vascularization by use of ultrasonography including power Doppler
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Condition category
Condition code
Inflammatory and Immune System
257244
257244
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0
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Rheumatoid arthritis
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Musculoskeletal
257245
257245
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Patients with active rheumatoid arthritis (RA) in spite of traditional disease modifying medication like methotrexate, with high clinical and laboratory disease activiy as well as increased symptoms of RA, will, according to national guidelines, be requested for treatment with biological medication (if there are no contraindications). All the biological treatments are high-cost medications and includes anti-Tumor Necrosis Treatment (anti-TNF): infliximab (Remicade), etanercept (Enbrel), adalimumab (Humira), golimumab (Simponi), anti-B-cell therapy; rituximab (MabThera), anti-T-cell therapy; abatacept (Orencia) and anti-Interleukin 6 (IL-6)(tocilizumab). The patient's rheumatologist will decide the indication for starting biological medication. Up till now clinical examination and assessment of inflammatory varibles (C-Reactive Protein (CRP) and Erythrocyte Sedimentation Rate (ESR)) are used to examine the response to this expensive treatment. However, ultrasonography (US) is found to be a valid and reliable method for detecting arthritis (synovitis, effusion and vascularization) with sensitivity almost like Magnetic Resonance Imaging (MRI), and highly more sensitive than clinical assessments. All the patients at dept. of rheumatology, Diakonhjemmet hospital, Oslo, Norway, starting one of the biological medications will be asked to participate in the present study. They will all be assessed by use of US of 36 joints (bilateral wrists; radiocarpal, intercarpal, radioulnar joints, MCP 1-5, PIP 2-3, elbow, knee, ankle; talocrural, MTP 1-5, extensor carpi ulnaris and tibialis posterior tendons) with scoring (semiquantitative 0-3) of the degree of synovitis and vascularization (power Doppler). In addition, the patients will be assessed traditionally (clinical, joint count, questionnaires, laboratory markers). All patients will be examined at baseline and after 1, 2, 3, 6 and 12 months. Patients will be recruited consecutively during one year.
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Intervention code [1]
256258
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Not applicable
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Comparator / control treatment
Not applicable
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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To assess whether ultrasonographic examination of 36 joints and 4 tendons will be able to indicate responders to biological medication earlier than regular assessments (clinical and laboratory)
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Assessment method [1]
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Timepoint [1]
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Assessments at baseline and after 1, 2, 3, 6 and 12 months.
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Secondary outcome [1]
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Degree of power Doppler activity at baseline and radiographic detorioration (hands and feet) after 12 months.
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Assessment method [1]
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Timepoint [1]
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Baseline power Doppler
12 months radiography
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Secondary outcome [2]
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Associations between ultrasonographic findings and clinical as well as laboratory assessments.
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Assessment method [2]
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Timepoint [2]
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Baseline and at 1, 2, 3, 6 and 12 months
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Eligibility
Key inclusion criteria
Patients with rheumatoid arthritis
Clinical indication for starting biological treatment
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Minimum age
18
Years
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Maximum age
85
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Not prosthesis in more than 5 of the joints examined by ultrasonography.
Not enough knowledge of the Norwegian language to answer questionnaires.
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/01/2010
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Actual
11/01/2010
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Date of last participant enrolment
Anticipated
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Actual
1/07/2014
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Date of last data collection
Anticipated
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Actual
1/08/2015
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Sample size
Target
200
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Accrual to date
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Final
296
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Recruitment outside Australia
Country [1]
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Norway
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State/province [1]
2567
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Abbott Norge AS
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Address [1]
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Martin Lingesv. 25, Box 1, N-1330 Fornebu
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Country [1]
256768
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Norway
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Funding source category [2]
256769
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Commercial sector/Industry
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Name [2]
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Roche Norge AS
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Address [2]
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Kristoffer Robinsv. 13, Box 41 Haugenstua, N-0915 Oslo
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Country [2]
256769
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Norway
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Funding source category [3]
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Commercial sector/Industry
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Name [3]
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Pfizer
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Address [3]
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Lilleakerv. 2B, Box 3, N-1324 Lysaker
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Country [3]
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Norway
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Primary sponsor type
Commercial sector/Industry
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Name
Abbott Norge AS
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Address
Martin Lingesv. 25, Box 1, N-1330 Fornebu
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Country
Norway
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Secondary sponsor category [1]
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Commercial sector/Industry
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Name [1]
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Roche Norge AS
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Address [1]
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Kristoffer Robinsv. 13, Box 41 Haugenstua, N-0915 Oslo
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Country [1]
256035
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Norway
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Secondary sponsor category [2]
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Commercial sector/Industry
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Name [2]
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Pfizer
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Address [2]
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Lilleakerv. 2B, Box 3, N-1324 Lysaker
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Country [2]
256038
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Norway
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Helse Sor-Ost, Regional Ethical Committee
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Ethics committee address [1]
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Oslo universitetssykehus, Ullev?l, Kirkeveien 166, N- 0450 Oslo
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Ethics committee country [1]
258769
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Norway
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Date submitted for ethics approval [1]
258769
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Approval date [1]
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07/10/2009
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Ethics approval number [1]
258769
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2009/ 1254
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Summary
Brief summary
Patients with active rheumatoid arthritis in spite of disease modifying anti-rheumatic drugs (DMARD) treatment should after international guidelines be treated with biological medication. The patients are followed regularly by use of clinical and laboratory examination to assess the response to treatment. Ultrasonography has been shown to be a valid and reliable method for assessing the degree of inflammation (grey scale) and vascularization (power Doppler). The present study will explore ultrasonography as a method to differentiate between responders and non-responders early in the treatment period. In addition, the ultrasonographic findings will be compared to radiographic, laboratory and clinical responses to therapy.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Hilde Berner Hammer
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Address
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Department of Rheumatology, Diakonhjemmet Hospital, Box 23 Vinderen, 0319 Oslo
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Country
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Norway
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Phone
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+4797723158
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Hilde Berner Hammer
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Address
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Department of Rheumatology, Diakonhjemmet Hospital, Box 23 Vinderen, 0319 Oslo
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Country
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Norway
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Phone
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+47 22451748
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Hilde Berner Hammer
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Address
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Department of Rheumatology, Diakonhjemmet Hospital, Box 23 Vinderen, 0319 Oslo
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Country
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Norway
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Phone
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+47 22451748
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Clinical, laboratory and ultrasound data may be shared
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When will data be available (start and end dates)?
From now to 1.1.2025
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Available to whom?
Scientists
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Available for what types of analyses?
Clinical, laboratory and ultrasound
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How or where can data be obtained?
By the PI of the study
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Calprotectin (S100A8/A9) has the strongest association with ultrasound-detected synovitis and predicts response to biologic treatment: Results from a longitudinal study of patients with established rheumatoid arthritis.
2017
https://dx.doi.org/10.1186/s13075-016-1201-0
Embase
Ultrasound of the hand is sufficient to detect subclinical inflammation in rheumatoid arthritis remission: A post hoc longitudinal study.
2017
https://dx.doi.org/10.1186/s13075-017-1428-4
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Assessing synovitis in the hands in patients with rheumatoid arthritis by ultrasound: An agreement study exploring the most inflammatory active side from two Norwegian trials.
2019
https://dx.doi.org/10.1186/s13075-019-1930-y
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Synovial hypertrophy without Doppler in the feet changes during treatment: Results from a longitudinal study of rheumatoid arthritis patients initiating biological treatment.
2020
https://dx.doi.org/10.1093/rheumatology/kez607
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Trajectories of fatigue in actively treated patients with established rheumatoid arthritis starting biologic DMARD therapy.
2020
https://dx.doi.org/10.1136/rmdopen-2020-001372
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Fatigue is cross-sectionally not associated with objective assessments of inflammation, but changes in fatigue are associated with changes of disease activity assessments during biologic treatment of patients with established rheumatoid arthritis.
2021
https://dx.doi.org/10.1007/s10067-020-05402-y
N.B. These documents automatically identified may not have been verified by the study sponsor.
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