Synovial Biopsy Analysis in Rheumatic Disease: Consensus Items Developed by EULAR, OMERACT

A set of consensual analysis items have been developed by the EULAR Synovitis Study Group and the OMERACT Synovial Tissue Biopsy Group for the analysis of synovial biopsies in clinical practice and translational research.

The analysis items, published in Arthritis Care & Research, were developed by a task force made up of individuals from both groups. Task force members were consulted through a modified Delphi method, in which they received a 2-part written questionnaire regarding synovial biopsy analysis. The first part of the questionnaire referred to synovial biopsies in clinical practice and the second part described translational research. Each participant was asked to score each questionnaire item on a 5-point Likert scale. Items with a median score above 3.5 and a ≥70% agreement were selected for the subsequent round of questionnaires. The third and final round was conducted orally at the EULAR Congress in June 2017.

A total of 27 participants from 19 centers were contacted by email; 20 responded. Response rates for subsequent rounds were 100%. In response to the first clinical practice section, 20 of 44 items (45.5%) were selected for the final set. For translational research, 18 of 43 items (41.9%) were selected. Questionnaire items described protocol for 5 domains: (1) biopsy sampling, (2) biopsy processing, (3) histologic criteria, (4) staining and immunohistochemistry, and (5) biopsy interpretation and pathologist’s report. Translational research items also included guidelines for RNA analysis. Each item had been abstracted from existing literature.

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Further research is necessary to identify new guidelines for synovial biopsy handling and processing. However, the use of a validated consensus method strengthens the legitimacy of these findings and provides guidance for the standardization of synovial biopsy analysis.

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Najm A, Le Goff B, Orr C, et al. Standardisation of synovial biopsy analyses in rheumatic diseases: a consensus of the EULAR Synovitis and OMERACT Synovial Tissue Biopsy Groups [published online December 3, 2018]. Arthritis Res Ther. doi:10.1186/s13075-018-1762-1