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The US7 score is sensitive to change in a large cohort of patients with rheumatoid arthritis over 12 months of therapy
  1. Tina M Backhaus1,2,
  2. Sarah Ohrndorf2,
  3. Herbert Kellner3,
  4. Johannes Strunk4,
  5. Wolfgang Hartung5,
  6. Horst Sattler6,
  7. Christof Iking-Konert1,
  8. Gerd R Burmester2,
  9. Wolfgang A Schmidt7,
  10. Marina Backhaus1
  1. 1Department of Medicine III, Nephrology and Rheumatology, Universitätsklinikum UKE, Hamburg, Germany
  2. 2Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
  3. 3Department of Rheumatology, Krankenhaus Neuwittelsbach, Munich, Germany
  4. 4Department of Rheumatology, Krankenhaus Porz am Rhein, Cologne, Germany
  5. 5Department of Rheumatology and Clinical Immunology, Asklepios Klinikum Bad Abbach, Abbach, Germany
  6. 6Department of Rheumatology, Parkklinik Bad Dürkheim, Bad Dürkheim, Germany
  7. 7Immanuel Krankenhaus Berlin, Rheumaklinik Berlin-Buch, Berlin, Germany
  1. Correspondence to Dr Marina Backhaus, Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, Berlin D-10117, Germany; marina.backhaus{at}charite.de

Abstract

Purpose To determine the sensitivity to change of the US7 score among RA patients under various therapies and to analyze the effect of each therapeutic option over 1 year. To estimate predictors for development of destructive bone changes.

Methods Musculoskeletal ultrasound (US7 score), DAS28, CRP and ESR were performed in 432 RA patients at baseline and after 3, 6 and 12 months. The cohort was divided into four sub-groups: first-line DMARDs (Group 1; 27.3%), therapy switch: DMARDs to second DMARDs (Group 2; 25.0%), first-line biologic after DMARDs therapy (Group 3; 35.4%) and therapy change from biologic to second biologic (Group 4; 12.3%).

Results The US7 synovitis and tenosynovitis sum scores in grey-scale (GSUS) and power Doppler ultrasound (PDUS) as well as ESR, CRP decreased significantly (p<0.05) after 12 months in group 1 to 3. Group 1+2 also illustrated a significant change of DAS28 after 1 year (p<0.001). Only in Group 4, the US7 erosion sum score decreased significantly from 4.3 to 3.6 (p=0.008) after 1 year. Predictors capable of forecasting US erosions after one year were: higher score of US7 synovitis (p<0.001), of US7 erosions in GSUS (p<0.001), as well as of DAS28 (p<0.001) at baseline.

Conclusions The comparable developments of the US7 score with clinical and laboratory data illustrates its potential to reflect therapeutic response. Therefore, the novel US7 score is sensitive to change. Patients who switched from one biologic to another exhibited a significant decline in erosions after 12 months, while the erosions scores in the other groups were stable.

  • Rheumatoid Arthritis
  • Ultrasonography
  • Synovitis
  • DAS28
  • TNF-alpha

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