Ultrasound shows reduced tenosynovitis after biologics in RA

The use of ultrasound successfully showed the reduction of tenosynovitis in patients with rheumatoid arthritis before and after beginning treatment with biologic disease-modifying anti-rheumatic drugs, according to recently presented study data.

The study comprised 181 patients with rheumatoid arthritis (RA) who were examined with ultrasound at baseline and at 1-, 2- and 3-month intervals after beginning treatment. The examinations were performed by one sonographer with the same Siemens Acuson Antares machine, probe and settings. Tenosynovitis was seen in a high number of tendons at baseline.

Biologic disease-modifying anti-rheumatic drugs (bDMARDs) included etanercept (43%), rituximab (19%), infliximab (10%), adalimumab (8%), tocilizumab (6%), golimumab (5%), certolizumab pegol (5%) and abatacept (4%).

The changes from baseline were assessed using paired samples T-test. The mean sum score for gray scale was 2.7 and 1.6 for power Doppler, including 26% of patients with no gray scale inflammation and 51% with no power Doppler activity in any tendon. Mean baseline level of erythrocyte sedimentation rate (ESR) was 28.6, mean C-reactive protein (CRP) level was 14.2 and disease activity score (DAS28) was 4.6.

Both gray scale and power Doppler scores decreased after 1 month of treatment and even more significantly after 3 months, according to the researchers. ESR, CRP and DAS28 also decreased after 1 and 3 months.

Based on their results, the researchers concluded that the use of ultrasound in extensor carpi radialis tendon in the wrist and tibialis posterior tendon in the ankle should be considered candidates for inclusion in future ultrasound scoring in patients with RA. – by Shirley Pulawski

Reference:

Hammer HB, et al. Paper #907. Presented at: American College of Rheumatology Annual Meeting. Nov. 14-19, 2014; Boston.

Disclosure: The authors have no relevant financial disclosures.