Power Doppler in hand joints predicts therapeutic failure in treatment-naive women with early rheumatoid arthritis: A prospective study

IF 2.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics Pub Date : 2025-01-01 DOI:10.1016/j.clinsp.2025.100593

Karine Rodrigues da Luz , Jamil Natour , Marcelo de Medeiros Pinheiro , Giovanna S. Petterle , Marla Francisca dos Santos , Artur da Rocha Correa Fernandes , Rita Nely Vilar Furtado

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引用次数: 0

Abstract

Objective

This study aimed to determine whether ultrasound measurements of the hands could predict treatment failure in treatment-naive women with early rheumatoid arthritis.

Method

In a prospective case-control study, 48 women underwent blind assessments four times over 48-weeks, considering three failure stages: failure 1 (methotrexate), failure 2 (leflunomide), and failure 3 (adalimumab). Bilateral ultrasound exams evaluated wrist, 2nd, and 3rd Metacarpophalangeal Joints (MCPs), and Proximal Interphalangeal Joints (PIPs) for inflammatory indicators (synovial and tenosynovial proliferation using grayscale and Power Doppler [PD]) and joint damage (bone erosion and cartilage damage).

Results

The study involved 48 women, aged 47.7 ± 11.6 years, with an average disease duration of 7.5 ± 3.5 months. Of these, 41 (85.41 %) experienced failure 1, 25 (52 %) experienced failure 2, and 5 (10.5%) experienced failure 3. Predictors for failure 1 included PD/Q10 total score > 2.5 (OR = 18.00), PD/SQ10 total score > 5.0 (OR = 23.2), PD/Q MCP score > 1.5 (OR = 14.58), and PD/SQ MCP score > 3.0 (OR = 35). For failure 2, predictors encompassed PD/Q10 total score > 4.5 (OR = 4.81), PD/SQ10 total score > 9.5 (OR = 4.81), PD/Q MCP score > 2.5 (OR = 4.92), PD/SQ MCP score >5.0 (OR = 6.22), and PD/Q PIP score > 1.5 (OR = 6.66). In relation to failure 3, a PD/Q wrist score > 2.5 (AUC = 0.79; p = 0.035) was indicative.

Conclusions

Power Doppler proved to be a predictive indicator for treatment failure in early rheumatoid arthritis among treatment-naive women. It emerged as a predictor for both the initial and 2nd DMARD treatments, as well as the 1st immunobiological treatment, based on hand joint assessments.

Trial registration

Clinical trials.gov NCT04752748.

查看原文本刊更多论文

手关节功率多普勒预测早期类风湿关节炎妇女治疗失败：一项前瞻性研究

目的本研究旨在确定手的超声测量是否可以预测早期类风湿关节炎妇女治疗失败。方法在一项前瞻性病例对照研究中，48名妇女在48周内接受了4次盲评估，考虑了3个失败阶段：失败1（甲氨蝶呤）、失败2（来氟米特）和失败3（阿达木单抗）。双侧超声检查评估手腕、第二和第三掌指关节（MCPs）和近端指间关节（pip）的炎症指标（使用灰度和功率多普勒[PD]检查滑膜和腱鞘增生）和关节损伤（骨侵蚀和软骨损伤）。结果48例女性，年龄47.7±11.6岁，平均病程7.5±3.5个月。其中，41人（85.41%）经历了失败1,25人（52%）经历了失败2,5人（10.5%）经历了失败3。失败1的预测因子包括PD/Q10总分>；2.5 (OR = 18.00)， PD/SQ10总分>；5.0 (OR = 23.2)， PD/Q MCP评分>；1.5 (OR = 14.58)， PD/SQ MCP评分>；3.0（或= 35）。对于失败2，预测因子包括PD/Q10总分>；4.5 (OR = 4.81)， PD/SQ10总分>；9.5 (OR = 4.81)， PD/Q MCP评分>；2.5 (OR = 4.92)， PD/SQ MCP评分>；5.0 (OR = 6.22)， PD/Q PIP评分>；1.5（或= 6.66）。对于失败3，PD/Q手腕评分>；2.5 (auc = 0.79；P = 0.035)具有指示性。结论功率多普勒可作为早期类风湿关节炎治疗失败的预测指标。它是基于手部关节评估的初始和第二次DMARD治疗以及第一次免疫生物学治疗的预测因子。临床试验。gov NCT04752748。

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来源期刊

Clinics 医学-医学：内科

CiteScore

4.10

自引率

3.70%

发文量

129

审稿时长

52 days

期刊介绍： CLINICS is an electronic journal that publishes peer-reviewed articles in continuous flow, of interest to clinicians and researchers in the medical sciences. CLINICS complies with the policies of funding agencies which request or require deposition of the published articles that they fund into publicly available databases. CLINICS supports the position of the International Committee of Medical Journal Editors (ICMJE) on trial registration.