EVALUATION OF ULTRASOUND REMISSION CRITERIA IN PATIENTS WITH RHEUMATOID ARTHRITIS DURING TOCILIZUMAB THERAPY

Objective: to study the association of ultrasound (US) remission criteria with the clinical and laboratory indicators of inflammatory activity, functional status, and X-ray changes in patients with rheumatoid arthritis (RA) during tocilizumab (TCZ) therapy.Subjects and methods. The trial included 36...

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Main Authors: Rita Aleksandrovna Osipyants, D E Karateev, E Yu Panasyuk, G V Lukina, A V Smirnov, S I Glukhova, E N Aleksandrova, A V Volkov, E L Nasonov
Format: Article
Language:Russian
Published: IMA PRESS LLC 2013-12-01
Series:Научно-практическая ревматология
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Online Access:https://rsp.mediar-press.net/rsp/article/view/1335
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author Rita Aleksandrovna Osipyants
D E Karateev
E Yu Panasyuk
G V Lukina
A V Smirnov
S I Glukhova
E N Aleksandrova
A V Volkov
E L Nasonov
author_facet Rita Aleksandrovna Osipyants
D E Karateev
E Yu Panasyuk
G V Lukina
A V Smirnov
S I Glukhova
E N Aleksandrova
A V Volkov
E L Nasonov
author_sort Rita Aleksandrovna Osipyants
collection DOAJ
description Objective: to study the association of ultrasound (US) remission criteria with the clinical and laboratory indicators of inflammatory activity, functional status, and X-ray changes in patients with rheumatoid arthritis (RA) during tocilizumab (TCZ) therapy.Subjects and methods. The trial included 36 patients with RA (meeting the 1987 American College of Rheumatology (ACR) criteria) who had received TCZ for 6 months. The authors made a clinical and laboratory assessment of RA activity (DAS28-CRP, and SDAI), functional impairments (HAQ index) and US verification of wrist joint synovitis (a Voluson-i device, GE, 4-13-MHz linear transducer) at baseline and 6 months after therapy. No signs of grey-scale (B-mode) and power Doppler (PD) synovitis (B = 0; PD = 0) or minimal B-mode synovitis, and not more one PD hypervascular signal (В ≤1; PD ≤1) were arbitrarily taken as US remission criteria. Destruction changes were evaluated by hand and foot X-ray using the Sharp method modified by van der Heijde (SHS).Results. After 6 months of therapy, about 80% of the patients in clinical remission retained moderate or significant synovitis, as evidenced by US studies. There were no clinical differences in clinical activity indices and functional impairments between the patients who were and were not in US remission (p > 0.05). The 12-month follow-up SHS score was significantly higher with the preservation of 6-month therapy signs of B-mode synovitis and PD hypervascularization (of not more than one signal) than that in US remission (p < 0.05). There was no relationship of X-ray progression to the clinical and functional statuses (p > 0.05).Conclusion. Subclinical synovitis is observed even in clinical remission of RA. Destruction progression is significantlyrelated to synovitis persistence, as shown by ultrasonography.
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spelling doaj-art-e001308b61b545fcaff463d65cd7a6fb2025-08-20T03:01:55ZrusIMA PRESS LLCНаучно-практическая ревматология1995-44841995-44922013-12-0151550050610.14412/1995-4484-2013-15401275EVALUATION OF ULTRASOUND REMISSION CRITERIA IN PATIENTS WITH RHEUMATOID ARTHRITIS DURING TOCILIZUMAB THERAPYRita Aleksandrovna Osipyants0D E Karateev1E Yu Panasyuk2G V Lukina3A V Smirnov4S I Glukhova5E N Aleksandrova6A V Volkov7E L Nasonov8V.A. Nasonova Research Institute of Rheumatology, Russian Academy of Medical Sciences, MoscowV.A. Nasonova Research Institute of Rheumatology, Russian Academy of Medical Sciences, MoscowV.A. Nasonova Research Institute of Rheumatology, Russian Academy of Medical Sciences, MoscowV.A. Nasonova Research Institute of Rheumatology, Russian Academy of Medical Sciences, MoscowV.A. Nasonova Research Institute of Rheumatology, Russian Academy of Medical Sciences, MoscowV.A. Nasonova Research Institute of Rheumatology, Russian Academy of Medical Sciences, MoscowV.A. Nasonova Research Institute of Rheumatology, Russian Academy of Medical Sciences, MoscowV.A. Nasonova Research Institute of Rheumatology, Russian Academy of Medical Sciences, MoscowV.A. Nasonova Research Institute of Rheumatology, Russian Academy of Medical Sciences, MoscowObjective: to study the association of ultrasound (US) remission criteria with the clinical and laboratory indicators of inflammatory activity, functional status, and X-ray changes in patients with rheumatoid arthritis (RA) during tocilizumab (TCZ) therapy.Subjects and methods. The trial included 36 patients with RA (meeting the 1987 American College of Rheumatology (ACR) criteria) who had received TCZ for 6 months. The authors made a clinical and laboratory assessment of RA activity (DAS28-CRP, and SDAI), functional impairments (HAQ index) and US verification of wrist joint synovitis (a Voluson-i device, GE, 4-13-MHz linear transducer) at baseline and 6 months after therapy. No signs of grey-scale (B-mode) and power Doppler (PD) synovitis (B = 0; PD = 0) or minimal B-mode synovitis, and not more one PD hypervascular signal (В ≤1; PD ≤1) were arbitrarily taken as US remission criteria. Destruction changes were evaluated by hand and foot X-ray using the Sharp method modified by van der Heijde (SHS).Results. After 6 months of therapy, about 80% of the patients in clinical remission retained moderate or significant synovitis, as evidenced by US studies. There were no clinical differences in clinical activity indices and functional impairments between the patients who were and were not in US remission (p > 0.05). The 12-month follow-up SHS score was significantly higher with the preservation of 6-month therapy signs of B-mode synovitis and PD hypervascularization (of not more than one signal) than that in US remission (p < 0.05). There was no relationship of X-ray progression to the clinical and functional statuses (p > 0.05).Conclusion. Subclinical synovitis is observed even in clinical remission of RA. Destruction progression is significantlyrelated to synovitis persistence, as shown by ultrasonography.https://rsp.mediar-press.net/rsp/article/view/1335rheumatoid arthritis remissionjoint ultrasonographysubclinical synovitisx-ray destruction progressiontocilizumab
spellingShingle Rita Aleksandrovna Osipyants
D E Karateev
E Yu Panasyuk
G V Lukina
A V Smirnov
S I Glukhova
E N Aleksandrova
A V Volkov
E L Nasonov
EVALUATION OF ULTRASOUND REMISSION CRITERIA IN PATIENTS WITH RHEUMATOID ARTHRITIS DURING TOCILIZUMAB THERAPY
Научно-практическая ревматология
rheumatoid arthritis remission
joint ultrasonography
subclinical synovitis
x-ray destruction progression
tocilizumab
title EVALUATION OF ULTRASOUND REMISSION CRITERIA IN PATIENTS WITH RHEUMATOID ARTHRITIS DURING TOCILIZUMAB THERAPY
title_full EVALUATION OF ULTRASOUND REMISSION CRITERIA IN PATIENTS WITH RHEUMATOID ARTHRITIS DURING TOCILIZUMAB THERAPY
title_fullStr EVALUATION OF ULTRASOUND REMISSION CRITERIA IN PATIENTS WITH RHEUMATOID ARTHRITIS DURING TOCILIZUMAB THERAPY
title_full_unstemmed EVALUATION OF ULTRASOUND REMISSION CRITERIA IN PATIENTS WITH RHEUMATOID ARTHRITIS DURING TOCILIZUMAB THERAPY
title_short EVALUATION OF ULTRASOUND REMISSION CRITERIA IN PATIENTS WITH RHEUMATOID ARTHRITIS DURING TOCILIZUMAB THERAPY
title_sort evaluation of ultrasound remission criteria in patients with rheumatoid arthritis during tocilizumab therapy
topic rheumatoid arthritis remission
joint ultrasonography
subclinical synovitis
x-ray destruction progression
tocilizumab
url https://rsp.mediar-press.net/rsp/article/view/1335
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