Trend of the Same Synovitis Changes in Rheumatoid Arthritis on Biological Therapy: Do we Really Need a Comprehensive US Assessment of Joints?
|Ying-Chou Chen*, Chi-Hua Ko, Wen-Chan Chiu, Fu-Mei Su and Jia-Feng Chen|
|Department of Rheumatology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan|
|Corresponding Author :||Ying-Chou Chen
Department of Rheumatology
Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine
Kaohsiung, Taiwan, #123, Ta-Pei Road, Niao-Sung District, Kaohsiung 833, Taiwan
E-mail: [email protected]
|Received: August 24, 2015; Accepted: September 29, 2015; Published: October 10, 2015|
|Citation: Ying-Chou C, Chi-Hua K, Wen-Chan C, Fu-Mei S, Jia-Feng C (2015) Trend of the Same Synovitis Changes in Rheumatoid Arthritis on Biological Therapy: Do we Really Need a Comprehensive US Assessment of Joints?. J Arthritis 4:170. doi:10.4172/2167-7921.1000170|
|Copyright: © 2015 Chen YC, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
Purpose: Comprehensive evaluation, including multiple recesses of all accessible peripheral joints, may be overly time-consuming in daily practice and in conducting clinical trials. This study aimed to investigate serial changes in synovitis activity at different joint level by ultrasonography (US) assessment of patients with rheumatoid arthritis (RA) on biological therapy and to determine simplified method of monitoring these patients and to search the lesser time consuming and can be used in clinical practice method.
Methods: Patients with RA who received biological therapy were enrolled. All underwent power Doppler US assessment of 24 synovial sites A total of 396 joints and 792 synovial sites underwent power Doppler US assessment for five times (at baseline and at 1, 3, 6 and 12 months after biological therapy). A general lineal model was used to compare differences among the 12 sites. Findings: Thirty-three patients, 1980 joints, and 3960 synovial sites were evaluated. There were no significant differences in grayscale (p=0.335) and PD ultrasound (p=0.623) changes in the elbow, wrist, MCP, PIP, knee, and ankle joints.
Implications: After 12 months, there are no differences among the 12 joints surveyed. It is not recommended to conduct full work-ups on more than one joint in clinical practice. Instead, a simplified joint evaluation is all that is required to avoid unnecessary time consumption.