Prediction of therapeutic responses with ultrasonography in RA patients treated with an anti-TNF drug: a retrospective cohort study. Issue 3 (3rd July 2018)

• Record Type: Journal Article
• Authors: Nozaki, Yuji; Ri, Jinhai; Sakai, Kenji; Shiga, Toshihiko; Inoue, Asuka; Nagare, Yasuaki; Funauchi, Masanori; Matsumura, Itaru
• Is Part Of: Immunological medicine. Volume 41:Issue 3(2018)
• Page Start: 129
• Page End: 135
• Publication Date: 2018-07-03
• Subjects: Clinical remission -- rheumatoid arthritis -- anti-TNF therapy -- ultrasound; Immune System Phenomena; Immune System Diseases; Immunology -- Periodicals; Immunology; Periodical; Periodicals; Electronic journals; 571.96
• DOI: 10.1080/25785826.2018.1531192
• Languages: English
• ISSNs: 2578-5826

Abstract

Abstract: Objective: Ultrasound (US) is more sensitive and reliable than a clinical examination, and is better correlated with the disease activity in rheumatoid arthritis (RA). We conducted the present study to assess the value of US as a screening tool to predict therapeutic responses in RA patients treated with anti-tumor necrosis factor (TNF) drugs. Methods: We retrospectively analyzed the cases of 86 consecutive RA patients who were classified by their DAS28-CRP scores at the 54th week. We assessed two US findings (i.e., the synovial hypertrophy index [SHI] and synovial vascularization) by grey-scale imaging and the Doppler synovitis index (DSI). Results: When we applied cut-off points determined by a ROC curve analysis, patients with a lower total SHI (≤34) or DSI (≤7) at baseline were significantly more likely to reach remission (44 patients, 51.2%) as shown by the DAS28-CRP at 54 weeks. On the basis of these cut-off values, we dichotomized all variables and performed a logistic regression analysis using the 54-weeks data; the only predictive factors of remission with anti-TNF therapy were the patients' baseline DAS28-CRP ≤2.7 as low disease activity/remission, and the SHI. Conclusion: An ultrasound assessment would be a highly useful predictor of the achievement of clinical remission.