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Hilde B. Hammer, Britt Birkelund and Tore K. Kvien, Dept. of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway Presentation Number: 172 Background/Purpose: Power Doppler (PD) ultrasonography
(US) detects inflammatory activity in patients with rheumatoid
arthritis (RA) and is highly responsive to anti-TNF treatment. The
present objective was to follow RA patients starting anti-TNF
treatment with PDUS and clinical assessments to explore whether any
Methods: Patients with RA starting anti-TNF
treatment were consecutively included and examined at baseline and
after 1, 2 and 3 months with US of 36 joints and 4 tendons (wrist
(radiocarpal, intercarpal and radioulnar), MCP 1-5, PIP 2 and 3,
elbow, knee, talocrural, MTP 1-5, extensor carpi ulnaris and
posterior tibialis tendons bilaterally). The PD and B-mode (BM)
synovitis were scored semi-quantitatively (0-3), and sum scores
from all joints and tendons were calculated. In addition, the
patients were assessed clinically with DAS28, assessor global VAS
(study nurse), ESR and CRP. Results: A total of 50 patients were included (mean (SD) age 51.7 (13.2) years, disease duration 7.8 (5.8) years, 74% anti-CCP positive and 84% women, with 38% using Remicade, 34% Enbrel, 16% Humira and 12% Simponi). A total of 57% of the patients were defined as PD responders, and they had significantly lower DAS28, assessors global VAS and number of swollen joints (p=0.023-0.031) at the 3 months examination. Baseline values of sum scores PD or BM, DAS28, assessors global VAS, ESR or CRP did not separate between responders and non-responders. At 1 month examination the only variable differing between responders and non-responders was the sum score PD, with a significant reduction in sum score PD in the responders versus non-responders 7.4 (8.6) versus -0.5 (7.3) (p = 0.002, figure 1A and B). Conclusions: PD activity is associated to erosions in RA patients. However, in the present study more than half of the patients achieved a major decrease in PD scores after starting anti-TNF treatment. It is an advantage to identify responders early, and the present results indicate that a significant reduction of PD activity already after 1 month predicts response to biological treatment. |
抗TNF治疗RA患者有效者在一个月后可见能量多普勒超声活性显著的下降 Hammer HB,et al. ACR 2011. Presentation Number: 172
背景／目的:
能量多普勒（PD)超声影像（US）能检测活动性类风湿关节炎（RA)的炎症活动度,
并对抗TNF治疗高度敏感。本研究目的是随访开始接受抗TNF治疗的RA患者的PDUS和临床指标,
以探索可以预测
方法:
连续纳入开始接受抗TNF治疗的RA患者,
并纪录其36个关节和4个肌腱（腕（桡掌、掌间和桡尺）、MCP1-5,PIP2／3, 结果: 总共纳入50例患者, 平均 （SD) 年龄为51.7(13.2)岁, 病程7.8(5.8)年, 74％患者抗CCP抗体阳性, 84％为女性, 用药情况为38％类克、34％恩利、16％修美乐以及12％戈利木单抗。 其中57％患者定义为PD有效者, 并在3个月随访时有DAS28、总体目测评估值和肿胀关节数的显著改善（P=0.023-0.031）。基线水平时的总PD积分、BM、DAS28、总体目测评估值、ESR或CRP在有效或无效患者组中并无差异。1个月随访时, 只有总PD积分在两组中有差异, 其在有效患者组中明显减少7.4(8.6),而无效组中为-0.5(7.3) (P=0.002,图1A和B).
结论: PD的活动度与RA患者的骨侵蚀相关。本研究中,
超过半数的患者在接受抗 |
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