Z Hu1, M Xu1, Q Wang2, J Qi1, Q Lv1, J Gu3. 1. Department of Rheumatology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. 2. Department of Ultrasound, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. 3. Department of Rheumatology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. gujieruo@163.com.
Abstract
OBJECTIVES: To investigate whether colour Doppler ultrasonography (CDUS) can be used to detect the effect of adalimumab on sacroiliitis and peripheral enthesitis in patients with ankylosing spondylitis (AS). METHODS: AS patients (n=41) received 40 mg adalimumab every other week for 24 weeks. BASDAI, BASFI, CRP, MRI examinations of the sacroiliac joints (SIJs) and CDUS examinations of both SIJs and 10 peripheral entheseal sites were taken at baseline, week 12, and week 24. We scored the MR images by SPARCC method, recorded the resistive index (RI) value of SIJs and graded the blood signal on a semi quantitative 0-3 scale. We also scored lesions of peripheral entheses seen by CDUS. We analysed the associations between the results of CDUS and clinical indices and MRI data. RESULTS: Significant reduction in mean CDUS score of SIJs and peripheral enthesitis and increase in mean RI value were observed in AS patients treated with adalimumab for 12 weeks and 24 weeks as compared with baseline (all p<0.05). The CDUS scores of SIJs and peripheral enthesitis positively related with clinical assessments (including BASDAI, BASFI, and CRP), while the RI value negatively related with them at all visits (all p<0.05). The results of CDUS also correlated well with the MRI data (all p<0.05) during adalimumab treatment in AS patients. CONCLUSIONS: Our study found that CDUS could be used to detect the changes of sacroiliitis and peripheral enthesitis in AS patients under adalimumab therapy.
OBJECTIVES: To investigate whether colour Doppler ultrasonography (CDUS) can be used to detect the effect of adalimumab on sacroiliitis and peripheral enthesitis in patients with ankylosing spondylitis (AS). METHODS: AS patients (n=41) received 40 mg adalimumab every other week for 24 weeks. BASDAI, BASFI, CRP, MRI examinations of the sacroiliac joints (SIJs) and CDUS examinations of both SIJs and 10 peripheral entheseal sites were taken at baseline, week 12, and week 24. We scored the MR images by SPARCC method, recorded the resistive index (RI) value of SIJs and graded the blood signal on a semi quantitative 0-3 scale. We also scored lesions of peripheral entheses seen by CDUS. We analysed the associations between the results of CDUS and clinical indices and MRI data. RESULTS: Significant reduction in mean CDUS score of SIJs and peripheral enthesitis and increase in mean RI value were observed in AS patients treated with adalimumab for 12 weeks and 24 weeks as compared with baseline (all p<0.05). The CDUS scores of SIJs and peripheral enthesitis positively related with clinical assessments (including BASDAI, BASFI, and CRP), while the RI value negatively related with them at all visits (all p<0.05). The results of CDUS also correlated well with the MRI data (all p<0.05) during adalimumab treatment in AS patients. CONCLUSIONS: Our study found that CDUS could be used to detect the changes of sacroiliitis and peripheral enthesitis in AS patients under adalimumab therapy.