Background Adalimumab is a TNF-α blocking agent that it is effective in patients with ankylosing spondylitis (AS). Ultrasonography can be used to detect sacroiliitis and peripheral enthesitis.

Objectives To investigate whether color Doppler ultrasonography (CDUS) can be used to detect the effect of adalimumab on sacroiliitis and peripheral enthesitis in patients with AS.

Methods AS patients (n=41) received 40 mg adalimumab every other week for 24 weeks. BASDAI, BASFI, CRP, MRI examinations of the sacroiliac joints (SIJs) and CDUS examinations of both SIJs and 10 peripheral entheseal sites were taken at baseline, week 12, and week 24. We scored the MR images by SPARCC method. We recorded the resistive index (RI) value of SIJs and graded the blood signal on a semi quantitative 0-3 scale. We also scored lesions of peripheral entheses seen by CDUS. We analyzed the associations between the results of CDUS and clinical indices and MRI data.

Results Significant reduction in mean CDUS score of SIJs and peripheral enthesitis and increase in mean RI value were observed in AS patients treated with adalimumab for 12 weeks and 24 weeks as compared with baseline (all p<0.05). The CDUS scores of SIJs and peripheral enthesitis positively related with clinical assessments (including BASDAI, BASFI, and CRP), while the RI value negatively related with them at all visits (all p<0.05). The results of CDUS also correlated well with the MRI data (all p<0.05) during the treatment of adalimumab in AS patients.

Conclusions Our study found that CDUS could be used to detect the changes of sacroiliitis and peripheral enthesitis in AS patients under the therapy of adalimumab.

References

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2. Mohammadi A, Ghasemi-rad M, Aghdashi M, et al. Evaluation of disease activity in ankylosing spondylitis; diagnostic value of color Doppler ultrasonography. Skeletal Radiol. 2013;42:219-24.

3. Kelly S, Taylor P, Pitzalis C. Ultrasound imaging in spondyloathropathies: from imaging to diagnostic intervention. Curr Opin Rheumatol. 2008;20:408-15.

Disclosure of Interest None declared