Objectives The aim of this study was to check whether synovial power Doppler (PD) and gray-scale (GS) ultrasound (US) scores could predict radiographic progression better than conventional measures in rheumatoid arthritis (RA) patients receiving biological agents (Bio).
Methods Participants comprised 127 patients with RA who had recently received Bio. Patients underwent clinical and laboratory assessments every 2 months from baseline to 12 months, and US assessments at baseline and 6 and 12 months. GS and PD signals were scored using a semi-quantitative scale from 0 to 3 at 26 synovial sites (22 joints) in the following joints: bilateral first to fifth metacarpopharangeal (MCP) joints (dorsal recess); first interphalangeal (IP) and second to fifth proximal interphalangeal (PIP) (dorsal recess) joints; and the wrists (dorsal radial, median and ulnar). Radiographic damage to the hands and feet was evaluated using van der Heijde modified total Sharp score (TSS) at baseline and 12 months.
Results Eighty-one patients finished a 12-month observation period. Univariate analysis revealed ΔTSS was significantly correlated with total GS scores at baseline (γ=0.318, P<0.05), and total PD scores at baseline (γ=0.262, P<0.05) and 6 months (γ=0.308, P<0.05). Furthermore, after adjusting for risk factors for joint destruction, including age, sex, duration of disease and previous Bio treatments, multivariate analysis also revealed that ΔTSS correlated significantly with total GS scores at baseline (β=0.342, P<0.05), and total PD scores at baseline (β=0.275, P<0.05) and 6 months (β=0.336, P<0.05). However, Disease Activity Score 28–CRP (DAS) did not correlate with ΔTSS.
Conclusions Our data confirm the evidence that synovial PD activity more accurately reflects active synovial inflammation (which actually causes joint destruction) than conventional measures in RA patients treated using Bio. As a predictor of radiographic damage, US assessment is superior to DAS.
Disclosure of Interest K. Mamoto: None declared, K. Inui: None declared, T. Okano: None declared, Y. Sugioka: None declared, M. Tada: None declared, T. Koike Grant/research support from: Takeda Pharmaceutical, Mitsubishi Tanabe Pharma Corporation, Chugai Pharmaceutical, Eisai, Abbott Japan, Teijin Pharma, Banyu Pharmaceutical and Ono Pharmaceutical, H. Nakamura: None declared