Session Type: Abstract Submissions (ACR)
Serum matrix metalloproteinase-3 (MMP-3) is useful bio markers of synovitis associated with rheumatoid arthritis (RA). Ultrasonography (US) has recently become more popular as a method of evaluating joint synovitis. The purpose of this study is to determine the significance of grey scale ultrasonography (GSUS) and power Doppler ultrasonography (PDUS) scores by comparison with serum biomarkers and clinical disease activity assessment.
We selected 151 consecutive patients with RA at our hospital outpatient clinic. The patients underwent musculoskeletal ultrasonography at 26 synovial sites in the following joints: bilateral first to fifth MCP (dorsal recess), first IP and second to fifth PIP (dorsal recess) joints and the wrists (dorsal radial, dorsal median and dorsal ulnar). The GS and power PD signals were scored in each joint using a scale from 0 to 3. The GSUS and PDUS scores are the sums of the scores obtained for the 26 synovial sites. Correlations among serum CRP, ESR and MMP-3 values and disease activity evaluated using the DAS28-ESR, DAS28-CRP, SDAI, CDAI were analyzed along with the PDUS positive ratio in patients in remission and in patients with normal MMP-3 values.
The clinical characteristics of the 151 patients (128 females and 23 males; mean age, 60.5 ± 13.1 years) with RA were as follows. They received only DMARDs (n = 80), and biological DMARDs (n = 71). The GSUS and PDUS scores were significantly and positively correlated with ESR, CRP, MMP-3, DAS28-ESR, DAS28-CRP, SDAI and CDAI. The PDUS score >1 was positive in 28 of 34 patients (82.3%) in remission with DAS28-CRP (< 2.6) and in 52 of 61 (85.2%) with normal serum MMP-3 levels. The PDUS score >2 was positive in 10 of 34 (29.4%) patients in remission with DAS28-CRP and in 30 of 61 (49.2%) with normal serum MMP-3 levels. The levels of PDUS score in the remission patients using biological DMARDs was less than the remission patients using only DMARDs.
Both GSUS and PDUS scores were closely correlated with clinical disease activity and serum biomarkers. These results indicate that US findings accurately reflect the pathogenesis of RA. However, patients in remission and normal serum MMP-3 levels also had a high rate of positive PD scores. We considered that US is more accurate for clinically evaluating patients with RA.
Eli Lilly Japan,
Novartis Pharmaceutical Corporation,
Mitsubishi Tanabe Pharma Corporation,
Astellas Pharma Inc.,
Pfizer Japan Inc.,
Asahi Kasei Pharma Corporation,
Daiichi Sankyo Company,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/power-doppler-signal-is-frequently-positive-among-patients-with-rheumatoid-arthritis-in-clinical-remission-and-normal-serum-matrix-metalloproteinase-3-mmp-3-levels/