Power Doppler ultrasound accurately tracks rheumatoid arthritis treatment response


NEW YORK (Reuters Health), Oct 1 - Power Doppler ultrasonography accurately monitors the response of rheumatoid arthritis (RA) to treatment with antitumor necrosis factor (TNF) agents, according to a report in the August issue of Arthritis & Rheumatism.

"Power Doppler ultrasonography is more sensitive and possibly more predictive than clinical evaluation in RA therapy monitoring," Dr. Esperanza Naredo from Hospital Severo Ochoa, Madrid, told Reuters Health. "Power Doppler ultrasonography can be a very useful tool for therapy monitoring in RA."

Naredo and colleagues investigated the utility of power Doppler ultrasonography assessment of synovitis and the response to anti-TNF therapy in 278 patients with RA.

Changes in power Doppler ultrasonography parameters paralleled clinical and functional measures of RA, the authors report, and changes in the power Doppler signal correlated significantly with changes in the Disease Activity Score (DAS) 28, ultrasound-measured synovial fluid, and ultrasound-measured synovial hypertrophy.

Moreover, the time-integrated values of the count of joints with power Doppler signal independently predicted progression in the radiographic erosion score and in the total radiographic score.

Changes in rheumatoid factor level and C-reactive protein level had weaker predictive values for radiographic changes, the investigators say.

"I recommend all rheumatologists ... use power Doppler ultrasonography for improving patients' care," Naredo said.

Naredo added that future studies include "therapy monitoring with power Doppler ultrasonography in early RA and other inflammatory arthritis to evaluate prognostic value of power Doppler ultrasonography."

By Will Boggs, MD

Arthritis Rheum 2008;58:2248-2256.

Last Updated: 2008-09-30 16:19:38 -0400 (Reuters Health)

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