This article is more than 5 years old. Information may no longer be current.
No significant differences seen in MSUS, DAS28-driven strategies for RA treatment
Click Here to Manage Email Alerts
There were no significant differences between a musculoskeletal ultrasound-driven treat-to-target strategy for patients with rheumatoid arthritis and a disease activity score in a 28 joints-driven strategy, although the musculoskeletal ultrasound-driven strategy yielded more intensive treatment, according to recent research.
“This study confirms that patients with newly diagnosed early [rheumatoid arthritis/undifferentiated arthritis] treated according to an intensive [treat-to-target] strategy have excellent short-term clinical, functional, health-related quality of life and imaging outcomes,” James Dale, MD, from the department of rheumatology at Wishaw General Hospital, North Lanarkshire, United Kingdom, and colleagues wrote in their study. “There will undoubtedly continue to be a major role for the use of [musculoskeletal ultrasound] in the management of patients with [rheumatoid arthritis], including assessment of disease activity, and informing treatment decisions when disease activity status is not clinically apparent.”
Dale and colleagues evaluated 111 patients with rheumatoid arthritis (RA) or undifferentiated arthritis who were treated with a strategy to reach disease activity score in 28 joints (DAS28) erythrocyte sedimentation rate (ESR) less than 3.2 or a combined DAS28-ESR less than 3.2 and musculoskeletal ultrasound assessment (MSUS) reaching a Doppler joint count up to 1, in which patients were included in the MSUS group if DAS28-ESR less than 3.2 or DAS28-ESR of at least 3.2 with two swollen joints, according to the abstract. The primary outcome was measuring DAS44 and RA MRI score (RAMRIS). Other methods included standardizing disease-modifying anti-rheumatic drug (DMARD) escalation to methotrexate monotherapy, triple therapy and etanercept (Enbrel, Amgen) and triple therapy and evaluation MRIs of the dominant hand and wrist with the Outcome Measures in Rheumatology (OMERACT), RAMRIS and van der Heijde/Sharp score evaluation at baseline at 18 months by two readers.
The researchers found significant improvements in DAS44 scores for both groups with a mean change of –2.58 for the control and –2.69 for the MSUS group (P = .72). DAS44 remission at 18 months was 44% in the control group and 66% in the MSUS group (P = .03), but there were no significant differences among any other American College of Rheumatology core-set variables, according to the abstract. Dale and colleagues reported limited MRI erosions and MRI progressions as well as no serious adverse events or imaging outcomes. – by Jeff Craven
Disclosure: Dale received grants from the Chief Scientist’s Office, Scottish Government and Pfizer and received personal fees and non-financial support from AbbVie and personal fees from Janssen and Pfizer. Please see the full study for a list of the other authors’ relevant financial disclosures.
Click Here to Manage Email Alerts