Suppress the joint destruction in clinical remission patients who have active synovitis of ultrasonographic assessment by increasing the dose of methotrexate - SCRUM study

Clinical remission according to composite indexes allowed the presence of subclinical active synovitis that might induce structural joint damages. Subclinical active synovitis should be controlled by additional treatment and this results in the prevention of the joint damage progression. Evaluation of subclinical active synovitis by using high resolution US should be important even in patients achieving clinical remission and it should be treated more intensively if active synovitis is positive.