Rheumatology Medical News about reduced synovial hyperplasia;high-resolution ultrasound;rituximab;RA

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High-resolution ultrasound confirms reduced synovial hyperplasia following rituximab treatment in rheumatoid arthritis
Rheumatology, 06/05/09

Ziswiler HR et al. – Findings show that high-resolution grey-scale ultrasonography (US) examination confirmed reduced synovial hyperplasia, but the applied power Doppler (PD) method displayed no significant changes. Therefore, only grey-scale US is recommended in follow-up examinations after rituximab (RTX) treatment.

Methods

Aim was to assess the response of RA pts to RTX treatment using a sensitive imaging technique for synovitis
23 RA pts were treated with two 1000-mg infusions of the B-cell depleting antibody, RTX
Clinical response was assessed by EULAR response criteria
High-resolution grey-scale and colour-coded PD ultrasonography was performed at baseline and 6 mo after RTX
The second to fifth MCP and PIP joints were bilaterally examined with joints in a neutral 0 position from a palmar view and scored from 0 to 3

Results

Median DAS28 improved from 5.03 to 3.56, which corresponded to a EULAR moderate response in 11/23 pts and a EULAR good response in another 6 pts
Improved control of disease activity by RTX was also indicated by tapering of median daily corticosteroid doses from 10 to 5 mg, without flare ups
Mean grey-scale scores correlated with the swollen joint count at baseline and mo 6
Mean grey-scale scores improved upon RTX from a 0.90 median to 0.75
Frequency of PD positive joints was low (6.1%) at baseline and did not change following RTX treatment

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