Background/Purpose:

The use of biological agents, or biologics, has revolutionized the treatment of rheumatoid arthritis (RA). Using power Doppler ultrasound, this study to evaluate the comparative efficacy of biologicals for refractory RA patients has been a trend. However, there were no standard exam to follow up on rheumatoid arthritis therapy. The primary objectives were to explore the associations between a comprehensive ultrasonographic (US) assessment of joints, tendons and bursae and previously described reduced joint counts (8-, 7-, 12-, 28) as well as to assess the sensitivity to change of these different US joint combinations during biological treatment.

Methods:

8-joint( bilateral elbow, wrist, MCP II and III) were involved in this study. 49 patients with rheumatoid arthritis (RA) were examined by US (B-mode (BM) and power Doppler (PD)) with use of a semi-quantitative (0 to 3) score of 34 joints, tendons/tendon groups at baseline and 1, 3, 6 and 12 months after initiating treatment with biological therapy. BM and PD scores for the different joint combinations were generated.

Results: The reduced 8-joint scores had high correlation coefficients with the 28-joint score at all examinations (range 0.87 to 0.94 for BM and 0.69 to 0.93 for PD, each P < 0.001) and sum BM and PD scores of all the different joint combinations improved significantly during follow-up (P ≤ 0.05 to 0.001).

Conclusion:

The reduced joint combinations were highly associated to the 28-joint score. Furthermore, all the joint combinations presently explored responded well to biological treatment. This indicates that an approach focusing on few joints and tendons gives equivalent information about the inflammatory activity in RA patients as a comprehensive US examination. The optimal combination of joints and tendons for a valid, reliable and feasible US measurement should be further explored to define a US score for follow-up of RA patients on biological treatment.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/reliability-of-8-joint-ultrasonography-scores-in-follow-up-of-biological-therapy-in-patients-with-rheumatoid-arthritis/