Artikel
Ultrasound (US) features of joint inflammation and radiologic progression in patients with rheumatoid arthritis (RA)
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Autoren
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Olga Alekseeva
- V.A. Nasonova Research Institute of Rheumatology, Moscow, Russian Federation
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Maria Severinova
- V.A. Nasonova Research Institute of Rheumatology, Moscow, Russian Federation
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Aleksandr Smirnov
- V.A. Nasonova Research Institute of Rheumatology, Moscow, Russian Federation
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Elena Luchikhina
- V.A. Nasonova Research Institute of Rheumatology, Moscow, Russian Federation
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Dmitrii Karateev
- V.A. Nasonova Research Institute of Rheumatology, Moscow, Russian Federation
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Aleksandr Volkov
- V.A. Nasonova Research Institute of Rheumatology, Moscow, Russian Federation
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Eugene Nasonov
- V.A. Nasonova Research Institute of Rheumatology, Moscow, Russian Federation
| Veröffentlicht: | 29. August 2016 |
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Gliederung
Text
Background: RA – a chronic inflammatory disease, which leads to destructive changes and dysfunction of joints. US is useful to evaluate the inflammation in RA patients.
The aim of this study is to detect the relationship between US power Doppler (PD) assessment of joint inflammation and radiologic progression in patients with RA.
Methods: 81 patients with RA (median age 56 [46; 62]) were treated by methotrexate (MTX) and/or biologic therapy in accordance with the treat-to-target concept. Clinical, laboratory parameters and US were performed at baseline and in 12, 24, 36 and 48 weeks after initiation of therapy. The wrist, MCP2 and MCP3, PIP2 and PIP3 joints, as well as MTP2 and MTP5 joints of the clinically dominant side were examined by US (GS and PD). The X-ray was conducted before treatment and at week 48 of therapy. Structural damage progression was evaluated by change in the Sharp van der Heijde score (ΔSHS) between baseline and 1 year. We categorized pts into 5 groups according to the occurrence of PD: 1) without PD throughout the observational period [the negative (N)], 2) positive PD limited to the period from the baseline to week 12 [the therapeutic response (R)], 3) positive PD limited to the period from the baseline to week 24-36 [the therapeutic late-response (LR)], 4) intermittent occurrence of PD in the observational period [the intermittently positive (IP)] and 5) with persistent positive PD throughout the observational period [the persistently positive (PP)].
Results: The active inflammation at the patient with radiographic progression was significantly higher at 48th week (OR 4,76, 95% CI 1,2–18,9, p = 0,018). The median PD in the group without radiographic progression was “0” (sensitivity-77%, specificity - 59%, AUC 0,698 p<0,024, 95% CI 0,544 - 0,852). ΔSHS in groups – N, R, LR, IP and PP – were depended on PD duration – mean level 0 (0;0); 0 (0;0); 0.35 (0;4); 1.36 (0;28) and 2.87 (0;20) respectively, but statistically significant differences were found between N and PP groups as well as R and PP groups.
Conclusion: PD-positive synovitis may have prognostic value to predict radiographic damage.
