Doppler ultrasound impacts response to intravenous tocilizumab in rheumatoid arthritis patients

ConclusionRA patients treated with IV-TCZ for 24  weeks demonstrated significant improvement, and baseline/early changes in PDUS were predictive of later clinical response. The PDUS 20/50/70 measure is a novel metric of response. This study suggests that IV-TCZ 4 mg/kg may not be sufficient to attain low RA disease activity at 12 weeks, in RA p atients with moderate to severe disease (DAS28 ≥ 4.4 and US34-PDUS ≥ 10).Trial registrationClinicalTrials.gov NCT01717859Key Points•Over 90% of RA patients with baseline DAS28-ESR ≥ 4.4 and PDUS34 ≥ 10 required intravenous tocilizumab dose escalation from 4 to 8  mg/kg at 12 weeks.•Reduction in power Doppler ultrasonography (US34-PDUS) scores correlate with DAS28-ESR and CDAI over 24  weeks in rheumatoid arthritis patients with moderate to severe disease activity.•Baseline US34-PDUS predicts future improvements in clinical disease activity outcomes, independent of baseline DAS28-ESR.•Clinical response measures, DAS28-ESR and CDAI, improved across US34-PDUS 20/50/70 categories, while patient-reported outcomes did not.

Source: Clinical Rheumatology - July 16, 2021 Category: Rheumatology Source Type: research