Document Detail


Ultrasound Doppler measurements predict success of treatment with anti-TNF-α drug in patients with rheumatoid arthritis: a prospective cohort study.
MedLine Citation:
PMID:  21071479     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the predictive ability of core outcomes applied in RA trials, including ultrasound (US) Doppler (USD) measurements differentiating patients who remain on anti-TNF-α therapy following 1 year.
METHODS: Patients with RA in anti-TNF-α therapy were followed 1 year after therapy initiation. All patients had wrist involvement. At baseline, 2 weeks, 26 weeks and 1 year a USD examination, clinical examination including tender and swollen joint count, visual analogue scale (VAS) global and HAQ, biochemical measures and 28-joint DAS (DAS28) were collected for all patients. The amount of USD signal in the synovium was quantified by measuring the percentage of colour pixels-the colour fraction (CF). Predictive validity for patients who remain on anti-TNF-α therapy after 1 year was assessed for both USD measurements and other disease measures. Baseline values of disease measures of patients who remained on treatment after 1 year was compared with those who stopped therapy.
RESULTS: The study cohort consisted of 109 patients. In this study, the baseline CF was the only measure predicting which patients would stay on the initial anti-TNF-α therapy for 1 year, evaluated using the square-root of CF (P = 0.024). The other disease markers could not significantly differentiate between the two groups of patients, with P-values of 0.86 and 0.98 for tender and swollen joint count, respectively, 0.86 for CRP, 0.24 for VAS, 0.10 for HAQ and 0.38 for DAS28.
CONCLUSION: There is now evidence to support that baseline USD, in contrast to clinical measures, can predict which patients will remain on anti-TNF-α 1 year after initiating therapy.
Authors:
Karen Ellegaard; Robin Christensen; Søren Torp-Pedersen; Lene Terslev; Christian C Holm; Merete J Kønig; Peter S Jensen; Bente Danneskiold-Samsøe; Henning Bliddal
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-11-11
Journal Detail:
Title:  Rheumatology (Oxford, England)     Volume:  50     ISSN:  1462-0332     ISO Abbreviation:  Rheumatology (Oxford)     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-22     Completed Date:  2012-02-21     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  100883501     Medline TA:  Rheumatology (Oxford)     Country:  England    
Other Details:
Languages:  eng     Pagination:  506-12     Citation Subset:  AIM; IM    
Affiliation:
The Parker Institute, Copenhagen University Hospital, Frederiksberg, Nordre Fasanvej 57, DK-2000, Frederiksberg, Denmark. parker@frh.regionh.dk.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Antibodies, Monoclonal / therapeutic use
Antibodies, Monoclonal, Humanized / therapeutic use
Antirheumatic Agents / therapeutic use*
Arthritis, Rheumatoid / drug therapy*,  ultrasonography*
Female
Humans
Immunoglobulin G / therapeutic use
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Receptors, Tumor Necrosis Factor / therapeutic use
Time Factors
Treatment Outcome
Tumor Necrosis Factor-alpha / antagonists & inhibitors*
Ultrasonography, Doppler*
Wrist Joint / ultrasonography
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/Antirheumatic Agents; 0/Immunoglobulin G; 0/Receptors, Tumor Necrosis Factor; 0/Tumor Necrosis Factor-alpha; 0/infliximab; 185243-69-0/TNFR-Fc fusion protein; FYS6T7F842/adalimumab

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