The US7 score is an effective tool of monitoring in patients with rheumatoid arthritis over 6 months of Tocilizumab

Abstract

Objectives: Musculoskeletal Ultrasonography (US) has increasingly been used as an outcome measure in clinical trials of RA. The German ultrasonography 7 (US7) score is a semiquantitative US scoring system that combined soft tissue changes (synovitis and tenosynovitis) and erosive bone lesions in seven preselected joints. We aimed to evaluate clinical and ultrasonographic evolution and their correlation in patients with rheumatoid arthritis (RA) treated with tocilizumab (TCZ) by using the German US7 score. Methods: Twenty-two consecutive patients, affected by RA [19 females, median age of 41 years (35, 50), median disease duration of 72 months (36,171)] who were none or partial responders to methotrexate were commenced on TCZ. The patients underwent clinical, laboratory, and ultrasonographic assessment at 3 visits (baseline and after 3 and 6 months). The Disease Activity Score in 28 joints (DAS28) was recorded at each visit. The German US7 score was performed to assess synovitis, tenosynovitis, erosions and synovial/tenosynovial vascularity. Clinical remission, defined by a DAS 28 < 2.6, was assessed at the 3 visits of follow-up. Results: At baseline, the median DAS28 score was 5.2 (4.4, 6.2) and the synovitis scores were 9.5 (6.7, 15) in GS ultrasound and 2.5 (0, 7.2) in PD ultrasound. After 6 months of therapy, the DAS28 significantly decreased to 1.6 (0.8, 2.4); p <0.001. GS and PD ultrasound scores significantly decreased respectively to 5 (4, 6); p=0.001 and to 0.5 (0, 1.7); p=0.04. Conclusion: The German US7 is effective to reflect the therapeutic response of RA patients under TCZ as same as clinical and biological findings. and functional status parameters changes and ultrasonographic findings variations 6 months after onset basing on the US7 score.