Development of a preliminary US power Doppler composite score for monitoring treatment in PsA
Rheumatology, 03/01/2012

Gutierrez M et al. – The present study provides a new working hypothesis that the sonographic core set may be useful to construct a PDUS composite score for the assessment of PsA. The Five Targets PD for Psoriatic Disease (5TPD) formula provides a feasible and reliable approach for multi–target monitoring of psoriatic disease.

• Sixteen PsA patients receiving anti–TNF–α therapy were enrolled.
• All patients were involved in multiple psoriatic targets, including joints, tendon, enthesis, skin and nail.
• The target with the highest PD signal, one for each target area, was selected to be scanned at baseline and at follow–up visit 8 weeks after.
• For each target, PD was graded according to semi–quantitative scoring systems.
• Inter– and intra–observer reliability and feasibility was also investigated.
• The new PD composite score for PsA was called Five Targets PD for Psoriatic Disease (5TPD).

• Sixty targets (16 joints, 9 tendons, 11 enthesis, 16 psoriatic plaques and 8 psoriatic onychopathies) were assessed.
• A significant improvement of the clinical scores was found at follow–up with respect to the baseline: HAQ modified for SpA (HAQ–S) (P=0.0001); Psoriasis Area and Severity Index (P=0.0001) and Nail Psoriasis Severity Index (P=0.35).
• The 5TPD showed a significant change between baseline and follow–up (P=0.0001).
• There was no significant correlation between HAQ–S and 5TPD findings.
• The inter– and intra–observer Κ–values varied from good to excellent at baseline and follow–up.
• The time spent on baseline US examinations was mean (s.d.) 10.5 (2.0) min and no more than 7 min for follow–up assessment.