Value of power Doppler ultrasound score of hand joints in predicting the therapeutic effects of tropizumab in thetreatment of moderate to severe rheumatoid arthritis

LI Yuan; QI Wufang

doi:10.7619/jcmp.201923003

Journal of Clinical Medicine in Practice > 2019 > 23(23): 9-13. > DOI: 10.7619/jcmp.201923003

LI Yuan, QI Wufang. Value of power Doppler ultrasound score of hand joints in predicting the therapeutic effects of tropizumab in thetreatment of moderate to severe rheumatoid arthritis[J]. Journal of Clinical Medicine in Practice, 2019, 23(23): 9-13. DOI: 10.7619/jcmp.201923003

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Value of power Doppler ultrasound score of hand joints in predicting the therapeutic effects of tropizumab in thetreatment of moderate to severe rheumatoid arthritis

LI Yuan,
QI Wufang

Department of Rheumatology and Immunology, Tianjin First Central Hospital, Tianjin, 300192

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Received Date: September 21, 2019
Available Online: February 28, 2021
Published Date: December 14, 2019

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Abstract

Abstract

Objective To analyze the value of power Doppler ultrasound score of hand joints (PD scores) in predicting the therapeutic effects of tropizumab (TCZ) in the treatment of moderate to severe rheumatoid arthritis (RA).
Methods Totally 80 patients with moderate to severe RA from April 2017 to April 2018 were selected and treated with TCZ at a dose of 8 mg/kg once per week for 24 weeks. At the same time, they were treated with DMARDs and hormones as appropriate. The levels of erythrocyte sedimentation rate (ESR), C reactive protein (CRP), white blood cell count (WBC), rheumatoid factor (RF), platelet count (PLT), 28 joint disease activity integral (DAS28)-ESR, DAS28-CRP and the synovial membrane thickness, the PD score of the hand joints at the time points of hospital admission, 12 weeks and 24 weeks of TCZ treatment were observed and analyzed in all the patients. The proportions of the patients met the standard of American College of Rheumatology (ACR) 20 at 12 weeks and 24 weeks of TCZ treatment were evaluated and analyzed.
Results With the implementation of TCZ treatment, the ESR, CRP, WBC, RF, PLT levels and DAS28-CRP, DAS28-ESR, synovial membrane thickness and PD score of hand joints of the patients at different time points gradually decreased, and there were significant differences between each time point (P < 0.05). At 12 weeks and 24 weeks of TCZ treatment, 43 cases (42.00%) and 54 cases (68.00%) met the ACR20 standard respectively. The area under receiver operating characteristic curve of PD score of hand joints at 12 weeks of TCZ treatment was 0.704 in predicting the ACR20 criteria at 24 weeks of TCZ treatment (P < 0.05), and the sensitivity and specificity were 0.875 and 0.529 under the Cut-off value.
Conclusion TCZ treatment can significantly alleviate the inflammatory response, reduce the disease activity and the joint synovial damages in patients with moderate to severe RA. The PD score of hand joints at 12 weeks of treatment can be used to predict the therapeutic effects at 24 weeks of treatment.
- hand joints,
- power Doppler ultrasound score,
- tropizumab,
- rheumatoid arthritis,
- therapeutic effects,
- prediction

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[1]	Davis J M 3^rd. Rheumatoid Arthritis: A Severe Disease That Preventive Approaches Would Greatly Benefit[J]. Clin Ther, 2019, 41(7): 1240-1245. doi: 10.1016/j.clinthera.2019.04.026
[2]	风湿免疫疾病慢病管理全国护理协作组. 类风湿关节炎患者的慢病管理专家共识(2014版)[J]. 中华风湿病学杂志, 2016, 20(2): 127-131.
[3]	Arnett F C, Edworthy S M, Bloch D A, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis[J]. Arthritis Rheum, 1988, 31(3): 315-324. doi: 10.1002/art.1780310302
[4]	Aletaha D, Neogi T, Silman A J, et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative[J]. Arthritis Rheum, 2010, 62(9): 2569-2581. doi: 10.1002/art.27584
[5]	Hartung W, Kellner H, Strunk J, et al. Development and evaluation of a novel ultrasound score for large joints in rheumatoid arthritis: one year of experience in daily clinical practice [J]. Arthritis Care Res, 2012, 64(5): 675-682. doi: 10.1002/acr.21574
[6]	郑西希, 张奉春. 人源化白细胞介素-6受体抗体在类风湿关节炎治疗中的应用[J]. 中华临床免疫和变态反应杂志, 2014, 8(4): 333-337. https://www.cnki.com.cn/Article/CJFDTOTAL-OZHL201404014.htm
[7]	苏哲, 张宁. 托珠单抗治疗中重度类风湿关节炎的临床研究[J]. 实用药物与临床, 2019, 22(5): 526-529. https://www.cnki.com.cn/Article/CJFDTOTAL-LYLC201905019.htm
[8]	陈兰芳, 强孚勇, 徐亮. 托珠单抗联合改善病情抗风湿药治疗中重度类风湿关节炎短期临床观察[J]. 中国临床药理学与治疗学, 2018, 23(12): 1386-1391. doi: 10.12092/j.issn.1009-2501.2018.12.012
[9]	崔赛赛, 付凌雨, 闫雷, 等. 塞妥珠单抗加甲氨蝶呤治疗活动性类风湿关节炎疗效和安全性的Meta分析[J]. 中国循证医学杂志, 2018, 18(2): 172-177. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZXZ201802008.htm
[10]	魏婷婷, 付凌雨, 辛芳冉, 等. 白细胞介素类生物制剂治疗类风湿关节炎安全性的Meta分析[J]. 风湿病与关节炎, 2018, 7(8): 27-33, 40. https://www.cnki.com.cn/Article/CJFDTOTAL-FSBG201808008.htm
[11]	罗阳, 冯菲, 王惠, 等. 超声技术诊断类风湿性关节炎缓解期的应用进展[J]. 中国医学影像技术, 2017, 33(5): 787-790. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYXX201705049.htm
[12]	Yoshimi R, Hama M, Minegishi K, et al. Ultrasonography predicts achievement of Boolean remission after DAS28-based clinical remission of rheumatoid arthritis[J]. Mod Rheumatol, 2014, 24(4): 590-598. doi: 10.3109/14397595.2013.857800
[13]	吴娇娇, 朱向明, 胡怡芳, 等. 7关节超声评分评估类风湿关节炎病情进展[J]. 中国医学影像技术, 2019, 35(5): 735-739. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYXX201905031.htm
[14]	吴娇娇, 朱向明, 胡怡芳, 等. 7关节超声评分在中西医治疗类风湿关节炎疗效评估中的应用[J]. 中国介入影像与治疗学, 2017, 14(9): 556-560. https://www.cnki.com.cn/Article/CJFDTOTAL-JRYX201709016.htm
[15]	Epis O, Filippucci E, Delle Sedie A, et al. Clinical and ultrasound evaluation of the response to tocilizumab treatment in patients with rheumatoid arthritis: a case series[J]. Rheumatol Int, 2014, 34(5): 737-742. doi: 10.1007/s00296-012-2638-3
[16]	do Prado A D, Bisi M C, Piovesan D M, et al. Ultrasound power Doppler synovitis is associated with plasma IL-6 in established rheumatoid arthritis[J]. Cytokine, 2016, 83: 27-32. doi: 10.1016/j.cyto.2016.03.014
[17]	许玲美, 朱绮芬, 杨旸. 托珠单抗在类风湿关节炎中的研究进展[J]. 世界临床药物, 2014, 35(9): 523-526. https://www.cnki.com.cn/Article/CJFDTOTAL-GWHH201409005.htm
[18]	叶丛, 朱盈姿, 余毅恺, 等. 托珠单抗治疗中至重度类风湿关节炎患者用药现状和依从性的单中心观察研究[J]. 中华风湿病学杂志, 2017, 21(10): 690-693.
[19]	陶洪. 托珠单抗对类风湿关节炎患者外周血单个核细胞的影响[D]. 武汉: 华中科技大学, 2015.

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Value of power Doppler ultrasound score of hand joints in predicting the therapeutic effects of tropizumab in thetreatment of moderate to severe rheumatoid arthritis

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