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Color Doppler ultrasound may detect joint changes in patients with AS undergoing Humira therapy
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Changes in sacroiliitis and peripheral enthesitis in patients with ankylosing spondylitis treated with Humira may be detected using color Doppler ultrasound, and findings were in agreement with concurrent MRI scores, according to a recently published study.
Researchers studied 41 patients (38 men) with ankylosing spondylitis (AS) diagnosed using the modified New York criteria who had an inadequate response to treatment with NSAIDs. Patients mean age 27.7 years with a mean disease duration of 7.2 years, and 39 were HLA-B27-positive. All had a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score of 4 or greater and back pain of 40 or greater on a VAS or duration of morning stiffness in excess of 1 hour. All patients were recruited between 2010 and 2013 from the Affiliated Hospital of Sun Yat-sen University in Guangzhou, China, and all began treatment with 40mg Humira (adalimumab, AbbVie) every other week at baseline.
In addition to BASDAI, patients were evaluated for the Bath Ankylosing Spondylitis Function Index (BASFI), and C-reactive protein (CRP) and underwent color Doppler ultrasound (CDUS) and MRI examinations at baseline, week 12 and week 24.
One of the study coauthors, blinded to treatment details and study design, performed the CDUS examinations using a 5-12 MHz linear array transducer (Aloka 5). Sacroiliitis and peripheral enthesitis were investigated at identical transducer orientation, adhering to standard planes and with other identical processing settings for each patient and scores for each location.
Patients underwent MRI evaluations of the sacroiliac joint (SIJs) using a 1.5T Signa Excite II scanner (GE Medical Systems). The images were scored by two independent readers in a random order and the mean score of the two investigators was used for analyses.
Following 12 weeks of treatment with adalimumab, BASDAI, BAFSI, CRP levels and CDUS scores in SIJs decreased, while the corresponding values of resistive indices increased. The findings on CDUS were consistent with changes on MRI. The effects remained stable or improved after 24 weeks of treatment in all parameters. – by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.
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