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Ultrasound7 versus ultrasound12 in monitoring the response to infliximab in patients with rheumatoid arthritis

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Abstract

This study aimed to assess the responsiveness of ultrasonography (US)-7 in patients with rheumatoid arthritis (RA). Eighty-two RA patients were recruited and followed up for 22 weeks. The clinical, laboratory, and X-ray assessments, along with grayscale US (GSUS) and power Doppler US (PDUS) examinations were performed at baseline, 6, 14, and 22 weeks after infliximab treatment. GSUS for synovitis and PDUS for synovitis and paratendinitis/tenosynovitis were assessed by a semi-quantitative (0 to 3) score, while GSUS for paratendinitis/tenosynovitis and bone erosion was qualitatively assessed as absent or present (0 or 1). US scores in both 7-joint (US7) and 12-joint (US12) systems were evaluated. After 6, 14, and 22 weeks of treatment with infliximab, indices such as US scores, 28-joint disease activity (DAS28) score, and tender and swelling joint count were all significantly improved compared to baseline. US7 scores were significantly correlated with that of US12. Strong correlations were identified between most US7 scores with DAS28, health assessment questionnaire (HAQ), and C-reactive protein (CRP) levels. When DAS28 was used as a reference, the US7 cutoff for disease remission was less than 35 for GS + PD and also less than 29 for GS and 1 for PD, respectively. Additionally, the positive percent agreement, negative percent agreement, and overall percent agreement for GS + PD were 77.78, 76.19, and 76.67 %, respectively, which were all higher than that of GS or PD. US7 may be a feasible tool to assess the therapeutic response in RA patients.

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Acknowledgments

The authors wish to thank Yuepeng Guo and Zhijing Qian for their enormous medical support and collaboration while working at the Medical Affairs Department of China Janssen. Both gave professional suggestions regarding this study and publication. Janssen China provided financial support for this study.

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    Authors and Affiliations

    1. Department of Rheumatology, Peking Union Medical College Hospital (West Campus), Chinese Academy of Medical Sciences, No. 41 Da Mu Cang, Western District, Beijing, 100032, China

      Xiaomei Leng, Zhonghui Xu, Wei Yu & Yan Zhao

    2. The First Hospital of China Medical University, Shenyang, China

      Weiguo Xiao, Jing Lu & Jiakai Wang

    3. The First Hospital of Wenzhou Medical College, Wenzhou, China

      Xiaochun Zhu, Xiaoru Xia & Yongji Li

    4. West China Hospital, Sichuan University, Chengdu, China

      Yi Liu, Yi Zhao & Honghu Tang

    5. Changhai Hospital of Shanghai, Shanghai, China

      Dongbao Zhao & Yeqing Shi

    6. Shanghai Changzheng Hospital, Shanghai, China

      Huji Xu, Jun Bao, Ling Chen, Li Lin & Ling Zhou

    7. The First People’s Hospital of Foshan, Foshan, China

      Guoqiang Chen & Hongwei Zhang

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    1. Xiaomei Leng
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    2. Weiguo Xiao
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    Corresponding author

    Correspondence to Yan Zhao.

    Ethics declarations

    The study (trial number: NCT01282528) was approved by the local ethics committee, and all eligible patients provided signed informed consent.

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    Additional information

    Xiaomei Leng, Weiguo Xiao and Zhonghui Xu contributed equally to this work.

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    Leng, X., Xiao, W., Xu, Z. et al. Ultrasound7 versus ultrasound12 in monitoring the response to infliximab in patients with rheumatoid arthritis. Clin Rheumatol 35, 587–594 (2016). https://doi.org/10.1007/s10067-016-3176-2

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    • DOI: https://doi.org/10.1007/s10067-016-3176-2

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