Power Doppler sonography monitoring of synovial perfusion at wrist joint in rheumatoid patients treated with adalimumab

E Filippucci ¹, A Iagnocco ², F Salaffi ¹, A Cerioni ¹, G Valesini ² and W Grassi ^1*

¹ Cattedra di Reumatologia, Università Politecnica delle Marche, Ancona, Italy
² Medical Therapy Department, Rheumatology Unit, La Sapienza University, Rome, Italy

^* To whom correspondence should be addressed. E-mail: walter.grassi{at}univpm.it.

Accepted 12 February 2006

Abstract

Objective: The aim of the present study was to use power Doppler sonography (PDS) in order to evaluate synovial perfusion changes induced by adalimumab in wrist joints of patients with rheumatoid arthritis (RA).

Methods: A total of 24 consecutive patients (18 female, 6 male) were recruited and 48 wrists examined. Patients with clinically active RA in spite of prior treatment with disease modifying antirheumatic drugs, including methotrexate were recruited in two rheumatological centres to receive 40 mg adalimumab administered subcutaneously every other week. Clinical, laboratory and PDS assessments were performed at 0, 2, 6 and 12 weeks. Clinical and laboratory measurements of disease activity included physician's global assessment of disease activity, erythrocyte sedimentation rate and serum levels of C-reactive protein. The Disease Activity Score for 28 joints (DAS 28) was calculated. PDS signal was scored from 0 to 3 according to the overall expression of PDS findings at wrist level.

Results: A statistically significant reduction of both clinical and PDS findings was found at all follow- up examinations. Positive correlations were demonstrated between reduction in PDS score and improvement in DAS 28 score at all follow-up examinations.

Conclusion: PDS detected a rapid and statistically significant reduction of synovial perfusion at wrist joint of patients with RA receiving adalimumab therapy. Ongoing follow-up will provide further information concerning the persistence of significant reduction in PDS signal score and its correlation with DAS 28.

Keywords: Power Doppler sonography, rheumatoid arthritis, therapy monitoring, wrist

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