Spondyloarthritis & psoriatic arthritis
'Double target' ultrasound monitoring of biologic therapy in psoriatic arthritis
Authors' conclusion
US was found sensitive for monitoring treatment response in PsA patients starting a biologic drug. Entheseal PD was less responsive than synovial PD, suggesting that enthesitis may represent a 'difficult-to-treat' domain in PsA.
Study context
- Population
- Consecutive psoriatic arthritis (PsA) patients with ultrasound (US) synovitis and US 'active' enthesitis starting a biologic disease-modifying anti-rheumatic drug (bDMARD)
- Participants
- 30 patients
- Exposure
- Synovial power Doppler (PD) response vs entheseal PD response at target sites during bDMARD therapy
- Outcome
- US response of target joint and enthesis (synovitis composite score grade 0; PD response = PD 0 and/or reduction ≥2 PD grades)
- Follow-up
- 3 and 6 months
Methodological detailsconsecutive patients, US 'double target' monitoring
- Consecutive patients
- US 'double target' monitoring
Main finding
As reported in the abstract
PD response, synovial vs entheseal · 3 months
P = 0.01
- Synovitis composite score, synovial PD and entheseal PD showed significant responses at 3 and 6 months vs baseline
- P < 0.01
Observational data: associations, not effects.
Further findings
PD response, synovial vs entheseal · 6 months
P = 0.02
Correlation of US synovitis responses with clinical responses
- Correlated with DAPSA response
- P < 0.01
- Correlated with MDA response, composite score
- P = 0.01
- Correlated with MDA response, PD
- P = 0.02
Original publication
'Double target' ultrasound monitoring of biologic therapy in psoriatic arthritis. Clin Exp Rheumatol. Published 30 June 2023. doi:10.
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