Doppler sonographic evaluation of effect of treatment with infliximab (Remicade) for rheumatoid arthritis

Abstract

Synovial vascularization in the knee joints of six patients with rheumatoid arthritis who were treated with infliximab was evaluated by Doppler sonography. Power Doppler sonography demonstrated a significant reduction of color flow signals (P < 0.05), and spectral Doppler sonography demonstrated a significant increase in vascular resistance (P < 0.05) at week 6 (after three injections) evaluation of the therapy. A significant decrease in the number of tender joints (P < 0.05) and C-reactive protein value (P < 0.05) was also observed in these patients.

Comparison in values of color flow signals and vascular resistance of synovial vascularity demonstrated by Doppler sonography between knee and metacarpophalangeal joints of patients with rheumatoid arthritis

“…In our previous studies of sonographic evaluation of synovial vascularity and vascular resistance, we have scanned knee joints. 5,11,12 Other investigators prefer to use the finger joints for studies of sonography, 3,8-10 presumably based on the assumption that small joints are more often affected by arthritis in RA patients. The present findings indicate that the Doppler sonographic scans of knee joints can clearly illustrate synovitis (especially synovial vascularity) in RA patients.…”

“…8,9 In previous studies of sonographic evaluation of synovial vascularity and vascular resistance, we scanned knee joints. 5,11,12 Metacarpophalangeal and PIP joints are the joints that have been most often scanned in studies of sonographic evaluation of synovitis in RA patients. 3,[8][9][10] However, there have been no significant comparisons of informativeness of Doppler sonographic findings between knee joints and MCP or PIP joints in the same RA patients.…”

Doppler sonographic comparative study on usefulness of synovial vascularity between knee and metacarpophalangeal joints for evaluation of articular inflammation in patients with rheumatoid arthritis treated by infliximab

“…3 Briefly, we used a Toshiba Aplio-80 system (Toshiba Medical Systems, Otawara, Japan) and a multidimensional linear scanner (PLT-704AT) at 5.3 MHz. Power Doppler sonography was performed using the standard method with a pulse repetition frequency of 11.7-12.2 Hz.…”

“…In those studies, various joints were used as scanning sites for Doppler sonography, including the wrist, 1,6 knee, [3][4][5]7 metacarpophalangeal (MCP) joint, 2,5,6 and proximal interphalangeal (PIP) joint. 1,6 The selection of those joints was not based on any experimental or clinical evidence.…”

“…To evaluate the therapeutic effect of tumor necrosis factor alpha (TNF-α) blockades on rheumatoid arthritis (RA), Doppler sonography of synovial vascularity has been successfully used to assess effects of infliximab [1][2][3][4] and etanercept [5][6][7] in patients with rheumatoid arthritis. In those studies, various joints were used as scanning sites for Doppler sonography, including the wrist, 1,6 knee, [3][4][5]7 metacarpophalangeal (MCP) joint, 2,5,6 and proximal interphalangeal (PIP) joint.…”