Ultrasound imaging using power Doppler signaling to assess damage and guide biopsy can help identify rheumatoid arthritis (RA) patients in remission who stand to benefit by getting off biologics, which suppress the immune system to considerable risk and can produce harsh side effects.
That’s according to a small study carried out in Italy and published in Arthritis Research & Therapy.
Gianfranco Ferraccioli, MD, of Catholic University of the Sacred Heart in Rome, and colleagues looked at 42 patients with rheumatoid arthritis in remission who, guided by ultrasound results, successfully tapered off the biologic drug category TNF- a (anti-tumor necrosis factor alpha).
After three months, 29 of the patients (69.1 percent) were still in remission, showing no power Doppler signals of the disease in ultrasound-guided biopsy of synovial tissue at the knee.
Of these 29, most (26 patients, 89.7 percent) saw their remission continue to the six-month mark.
The patients who relapsed went back on the pre-study biologic, and all had good results with it, according to the study.
The use of sequential ultrasound evaluations “may allow identification of an even higher proportion of those likely to reach persistent drug-free remission compared with using current clinical methods of disease activity assessment,” the authors write, adding that larger studies are needed to confirm their findings.