Ultrasonography used to guide drug modification in arthritis
Researchers found that ultrasonography of selected joints can improve clinical assessment.
HealthDay News — Ultrasonography can be useful for guiding modification of anti-rheumatic drugs and steroids for patients with inflammatory arthritis (IA), according to a study published in the International Journal of Rheumatic Diseases.
York Kiat Tan, MBBS, from Singapore General Hospital, and colleagues conducted a retrospective study involving 46 adult IA patients to examine the utility of ultrasonography in guiding modification of disease-modifying anti-rheumatic drug (DMARD) and steroid therapy. Data were analyzed for 37 patients with both power Doppler (PD) vascularity and greyscale (GS) synovial hypertrophy joint findings.
The researchers found that all 10 patients escalated and/or initiated on DMARD and 9 of 10 patients escalated or initiated on steroids were positive for PD and GS. PD-negative findings were seen in 6 of 7 patients with dose reduction and/or cessation of DMARDs and 5 of 7 with dose reduction or cessation of steroids. Six patients were GS-positive and PD-negative; of these, 3 had dose reduction or cessation of DMARDs and 4 had dose reduction of steroids; none had DMARD/steroid escalation.
"Ultrasonography of physician-selected joints can improve clinical assessment, resulting in treatment modification," the authors write. "Positive PD findings were particularly influential, while the clinical significance of GS positivity alone requires further investigation."
- Tan YK, Chew LC, Allen JC, et al. Utility of ultrasonography in guiding modification of disease modifying anti-rheumatic drugs and steroid therapy for inflammatory arthritis in routine clinical practice. Int J Rheum Dis. 2016; doi:1111/1756-185X.12933.