Department of Ultrasound, Lishui People's Hospital, Lishui, China.
Department of General Surgery, Lishui People's Hospital, Lishui, China.
Ultrasound Med Biol. 2021 Sep;47(9):2543-2549. doi: 10.1016/j.ultrasmedbio.2021.05.003. Epub 2021 Jun 24.
More research is needed into rheumatoid arthritis (RA), and ultrasound (US) synovitis is a promising factor for assisting in the management of RA; however, related research is extremely limited. The goal of this study was to evaluate the correlation of US synovitis joint count with clinical features, and its longitudinal changes with treatment response to etanercept in RA. We consecutively enrolled 117 people with active RA being treated with etanercept. US synovitis joint count was evaluated in 28 joints at baseline (W0), week 4 (W4), week 12 (W12) and week 24 (W24) after initiation of etanercept treatment. The mean (±standard deviation), median, inter-quartile range, and total range of the US synovitis joint count at W0 were 9.3 ± 4.0, 9.0, 7.0-11.0 and 2.0-21.0, respectively. US synovitis joint count was positively associated with tenderness joint count, swollen joint count, erythrocyte sedimentation rate, 28-joint Disease Activity Score based on erythrocyte sedimentation rate and Health Assessment Questionnaire-Disability Index score. Then participants were categorized into response and non-response groups according to their response status at W24. Further analyses showed that US synovitis joint count gradually decreased from W0 to W24, and displayed a more notable declining trend in the response group compared with the non-response group. In addition, US synovitis joint count at W0 and W4 was similar between groups, but at W12 and W24 it was markedly decreased in the response group compared with the non-response group. In conclusion, US synovitis joint count correlates with disease activity, and its longitudinal decrease is associated with treatment response to etanercept in RA.
需要对类风湿关节炎（RA）进行更多的研究，超声（US）滑膜炎是辅助 RA 管理的一个很有前途的因素；然而，相关的研究极其有限。本研究的目的是评估 US 滑膜炎关节计数与临床特征的相关性，及其与依那西普治疗 RA 时的治疗反应的纵向变化。我们连续纳入了 117 名正在接受依那西普治疗的活动期 RA 患者。在开始依那西普治疗后，分别在基线（W0）、第 4 周（W4）、第 12 周（W12）和第 24 周（W24）评估 US 滑膜炎关节计数。W0 时 US 滑膜炎关节计数的平均值（±标准差）、中位数、四分位数范围和总范围分别为 9.3±4.0、9.0、7.0-11.0 和 2.0-21.0。US 滑膜炎关节计数与压痛关节计数、肿胀关节计数、红细胞沉降率、基于红细胞沉降率的 28 关节疾病活动评分和健康评估问卷残疾指数评分呈正相关。然后，根据患者在 W24 时的反应状态，将患者分为反应组和非反应组。进一步分析表明，US 滑膜炎关节计数从 W0 逐渐减少到 W24，并且在反应组中比非反应组显示出更显著的下降趋势。此外，W0 和 W4 时两组间 US 滑膜炎关节计数相似，但在 W12 和 W24 时，反应组比非反应组明显减少。总之，US 滑膜炎关节计数与疾病活动度相关，其纵向减少与依那西普治疗 RA 的反应相关。
