Back to Search
Start Over
Predictive value of Doppler ultrasound-detected synovitis in relation to failed tapering of biologic therapy in patients with rheumatoid arthritis.
- Source :
-
Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2015 Aug; Vol. 54 (8), pp. 1408-14. Date of Electronic Publication: 2015 Mar 01. - Publication Year :
- 2015
-
Abstract
- Objective: To investigate the predictive value of synovitis detected by Doppler US in relation to failed tapering of biologic therapy (BT) in RA patients in sustained clinical remission.<br />Methods: A total of 77 RA patients (52 women, 25 men) in sustained clinical remission, treated with a stable dosage of BT were prospectively recruited. BT was tapered according to an agreed strategy implemented in clinical practice (i.e. increasing the interval between doses for s.c. BT and reducing the dose for i.v. BT). BT tapering failure was assessed at 6 and 12 months. Doppler US investigation of 42 joints for the presence and grade (0-3) of B-mode synovial hypertrophy and synovial power Doppler signal (i.e. Doppler synovitis) was performed at baseline by a rheumatologist blinded to clinical and laboratory data. Hand and foot radiographs were obtained at baseline and at 12-month follow-up.<br />Results: Of the 77 patients, 46 (59.7%) were on s.c. BT and 31 (40.3%) on i.v. BT. At 12 months, 35 patients (45.5%) presented BT tapering failure, 23 of them (29.9% of all patients) in the first 6 months of BT tapering. In logistic regression analysis, the baseline DAS28 and the global score of Doppler synovitis were identified as independent predictors of BT tapering failure at 12 and 6 months. The presence of Doppler synovitis was the strongest predictor for BT tapering failure. No patient showed radiographic progression.<br />Conclusion: Our results suggest that the presence of Doppler-detected synovitis may predict BT tapering failure in RA patients in sustained clinical remission.<br /> (© The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Foot Joints diagnostic imaging
Hand Joints diagnostic imaging
Humans
Logistic Models
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Radiography
Synovitis diagnosis
Time Factors
Treatment Failure
Treatment Outcome
Arthritis, Rheumatoid diagnostic imaging
Arthritis, Rheumatoid drug therapy
Biological Products therapeutic use
Synovial Membrane diagnostic imaging
Synovitis diagnostic imaging
Ultrasonography, Doppler methods
Subjects
Details
- Language :
- English
- ISSN :
- 1462-0332
- Volume :
- 54
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Rheumatology (Oxford, England)
- Publication Type :
- Academic Journal
- Accession number :
- 25731769
- Full Text :
- https://doi.org/10.1093/rheumatology/kev006