Value of ultrasonography as a marker of early response to abatacept in patients with rheumatoid arthritis and an inadequate response to methotrexate: results from the APPRAISE study
ObjectivesTo study the responsiveness of a combined power Doppler and greyscale ultrasound (PDUS) score for assessing synovitis in biologic-naïve patients with rheumatoid arthritis (RA) starting abatacept plus methotrexate (MTX).MethodsIn this open-label, multicentre, single-arm study, patients with...
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| Veröffentlicht in: | Annals of the rheumatic diseases 2016-10, Vol.75 (10), p.1763-1769 |
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| creator | D'Agostino, Maria-Antonietta Wakefield, Richard J Berner-Hammer, Hilde Vittecoq, Olivier Filippou, Georgios Balint, Peter Möller, Ingrid Iagnocco, Annamaria Naredo, Esperanza Østergaard, Mikkel Boers, Maarten Gaillez, Corine Van Holder, Karina Le Bars, Manuela |
| description | ObjectivesTo study the responsiveness of a combined power Doppler and greyscale ultrasound (PDUS) score for assessing synovitis in biologic-naïve patients with rheumatoid arthritis (RA) starting abatacept plus methotrexate (MTX).MethodsIn this open-label, multicentre, single-arm study, patients with RA (MTX inadequate responders) received intravenous abatacept (∼10 mg/kg) plus MTX for 24 weeks. A composite PDUS synovitis score, developed by the Outcome Measures in Rheumatology–European League Against Rheumatism (OMERACT–EULAR)-Ultrasound Task Force, was used to evaluate individual joints. The maximal score of each joint was added into a Global OMERACT–EULAR Synovitis Score (GLOESS) for bilateral metacarpophalangeal joints (MCPs) 2–5 (primary objective). The value of GLOESS containing other joint sets was explored, along with clinical efficacy.ResultsEighty-nine patients completed the 24-week treatment period. The earliest PDUS sign of improvement in synovitis was at week 1 (mean change in GLOESS (MCPs 2–5): −0.7 (95% CIs −1.2 to −0.1)), with continuous improvement to week 24. Early improvement was observed in the component scores (power Doppler signal at week 1, synovial hyperplasia at week 2, joint effusion at week 4). Comparable changes were observed for 22 paired joints and minimal joint subsets. Mean Disease Activity Score 28 (C reactive protein) was significantly reduced from weeks 1 to 24, reaching clinical meaningful improvement (change ≥1.2) at week 8.ConclusionsIn this first international prospective study, the composite PDUS score is responsive to abatacept. GLOESS demonstrated the rapid onset of action of abatacept, regardless of the number of joints examined. Ultrasound is an objective tool to monitor patients with RA under treatment.Trial registration numberNCT00767325. |
| doi_str_mv | 10.1136/annrheumdis-2015-207709 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5036216</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4204199491</sourcerecordid><originalsourceid>FETCH-LOGICAL-b555t-51da470855230e881e9d9fa204bbb0d721a927049a23afe1e677524f0c4545043</originalsourceid><addsrcrecordid>eNqNks9u1DAQxi0EomXhFcASFzgs2E4cxxwqrapCK61Exb-rNdlMmiyJndpOYR-M98NhS9X21Iut8fzm83j8EfKKs3ecZ8V7sNa3OA11F5aCcZkWpZh-RA55XpQpKthjcsgYy5a5LtQBeRbCNoWs5OVTciAKqRlX-SH58wP6Calr6NRHD8FZd-FhbHcUAgU6gP-Jfk4j-H5HPYbR2YA0OgoVRNjgGGln6QixQxsD_dXFlv7rDaLrago-tr6LXVKzKbIJhhovJ4h4R23A2Lro8XdKfJgzqZ9AG-8GGlukq_PzL6uzryc0xKnePSdPGugDvrjeF-T7x5Nvx6fL9edPZ8er9bKSUsal5DXkipVSioxhWXLUtW5AsLyqKlYrwUELxXINIoMGORZKSZE3bJPLXLI8W5Cjve44VQPWm_RCD70ZfZcGszMOOnM3Y7vWXLgrI1lWCF4kgbd7gfZe2elqbeYzJvJ0KVNXPLFvri_z7nLCEM3QhQ32PVh0UzC8FEpzXersASgvs0yr9P8L8voeunWTt2lqs6DUSspSJErtqY13IXhsbprlzMyOM7ccZ2bHmb3jUuXL2yO6qftvsQSIPVAN2wer_gWb7Oh3</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1825975582</pqid></control><display><type>article</type><title>Value of ultrasonography as a marker of early response to abatacept in patients with rheumatoid arthritis and an inadequate response to methotrexate: results from the APPRAISE study</title><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><creator>D'Agostino, Maria-Antonietta ; Wakefield, Richard J ; Berner-Hammer, Hilde ; Vittecoq, Olivier ; Filippou, Georgios ; Balint, Peter ; Möller, Ingrid ; Iagnocco, Annamaria ; Naredo, Esperanza ; Østergaard, Mikkel ; Boers, Maarten ; Gaillez, Corine ; Van Holder, Karina ; Le Bars, Manuela</creator><creatorcontrib>D'Agostino, Maria-Antonietta ; Wakefield, Richard J ; Berner-Hammer, Hilde ; Vittecoq, Olivier ; Filippou, Georgios ; Balint, Peter ; Möller, Ingrid ; Iagnocco, Annamaria ; Naredo, Esperanza ; Østergaard, Mikkel ; Boers, Maarten ; Gaillez, Corine ; Van Holder, Karina ; Le Bars, Manuela ; OMERACT-EULAR-Ultrasound Task Force</creatorcontrib><description>ObjectivesTo study the responsiveness of a combined power Doppler and greyscale ultrasound (PDUS) score for assessing synovitis in biologic-naïve patients with rheumatoid arthritis (RA) starting abatacept plus methotrexate (MTX).MethodsIn this open-label, multicentre, single-arm study, patients with RA (MTX inadequate responders) received intravenous abatacept (∼10 mg/kg) plus MTX for 24 weeks. A composite PDUS synovitis score, developed by the Outcome Measures in Rheumatology–European League Against Rheumatism (OMERACT–EULAR)-Ultrasound Task Force, was used to evaluate individual joints. The maximal score of each joint was added into a Global OMERACT–EULAR Synovitis Score (GLOESS) for bilateral metacarpophalangeal joints (MCPs) 2–5 (primary objective). The value of GLOESS containing other joint sets was explored, along with clinical efficacy.ResultsEighty-nine patients completed the 24-week treatment period. The earliest PDUS sign of improvement in synovitis was at week 1 (mean change in GLOESS (MCPs 2–5): −0.7 (95% CIs −1.2 to −0.1)), with continuous improvement to week 24. Early improvement was observed in the component scores (power Doppler signal at week 1, synovial hyperplasia at week 2, joint effusion at week 4). Comparable changes were observed for 22 paired joints and minimal joint subsets. Mean Disease Activity Score 28 (C reactive protein) was significantly reduced from weeks 1 to 24, reaching clinical meaningful improvement (change ≥1.2) at week 8.ConclusionsIn this first international prospective study, the composite PDUS score is responsive to abatacept. GLOESS demonstrated the rapid onset of action of abatacept, regardless of the number of joints examined. Ultrasound is an objective tool to monitor patients with RA under treatment.Trial registration numberNCT00767325.</description><identifier>ISSN: 0003-4967</identifier><identifier>EISSN: 1468-2060</identifier><identifier>DOI: 10.1136/annrheumdis-2015-207709</identifier><identifier>PMID: 26590174</identifier><language>eng</language><publisher>England: Elsevier Limited</publisher><subject>Abatacept - administration & dosage ; Adult ; Aged ; Antirheumatic Agents - administration & dosage ; Arthritis, Rheumatoid - complications ; Arthritis, Rheumatoid - diagnostic imaging ; Arthritis, Rheumatoid - drug therapy ; Biomarkers - analysis ; Bones ; C-reactive protein ; Clinical and Epidemiological Research ; Clinical medicine ; Doppler effect ; Drug dosages ; Drug Therapy, Combination ; Effusion ; Europe ; Female ; Humans ; Hyperplasia ; Immunology ; Intravenous administration ; Joint diseases ; Joints - diagnostic imaging ; Life Sciences ; Male ; Methotrexate ; Methotrexate - administration & dosage ; Middle Aged ; Patients ; Predictive Value of Tests ; Prospective Studies ; Rheumatism ; Rheumatoid arthritis ; Rheumatology ; Severity of Illness Index ; Synovitis ; Synovitis - diagnostic imaging ; Synovitis - drug therapy ; Synovitis - etiology ; Treatment Outcome ; Ultrasonic imaging ; Ultrasonography, Doppler - methods ; Ultrasound</subject><ispartof>Annals of the rheumatic diseases, 2016-10, Vol.75 (10), p.1763-1769</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 2016 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b555t-51da470855230e881e9d9fa204bbb0d721a927049a23afe1e677524f0c4545043</citedby><cites>FETCH-LOGICAL-b555t-51da470855230e881e9d9fa204bbb0d721a927049a23afe1e677524f0c4545043</cites><orcidid>0000-0002-5080-4790 ; 0000-0002-5025-0214 ; 0000-0001-5528-8070 ; 0000-0001-5757-074X ; 0000-0001-7432-847X ; 0000-0002-1647-2083 ; 0000-0002-3708-1460 ; 0000-0002-4293-8596 ; 0000-0002-6976-643X ; 0000-0003-1177-9497 ; 0000-0001-5959-9183 ; 0000-0001-8793-3644 ; 0000-0003-4002-1861 ; 0000-0002-4244-5417 ; 0000-0001-9349-0720 ; 0009-0009-9738-4066 ; 0000-0002-9815-2138 ; 0000-0002-1095-3492 ; 0000-0001-5592-724X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://ard.bmj.com/content/75/10/1763.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttp://ard.bmj.com/content/75/10/1763.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>114,115,230,314,777,781,882,3183,23552,27905,27906,77349,77380</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26590174$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-02467707$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>D'Agostino, Maria-Antonietta</creatorcontrib><creatorcontrib>Wakefield, Richard J</creatorcontrib><creatorcontrib>Berner-Hammer, Hilde</creatorcontrib><creatorcontrib>Vittecoq, Olivier</creatorcontrib><creatorcontrib>Filippou, Georgios</creatorcontrib><creatorcontrib>Balint, Peter</creatorcontrib><creatorcontrib>Möller, Ingrid</creatorcontrib><creatorcontrib>Iagnocco, Annamaria</creatorcontrib><creatorcontrib>Naredo, Esperanza</creatorcontrib><creatorcontrib>Østergaard, Mikkel</creatorcontrib><creatorcontrib>Boers, Maarten</creatorcontrib><creatorcontrib>Gaillez, Corine</creatorcontrib><creatorcontrib>Van Holder, Karina</creatorcontrib><creatorcontrib>Le Bars, Manuela</creatorcontrib><creatorcontrib>OMERACT-EULAR-Ultrasound Task Force</creatorcontrib><title>Value of ultrasonography as a marker of early response to abatacept in patients with rheumatoid arthritis and an inadequate response to methotrexate: results from the APPRAISE study</title><title>Annals of the rheumatic diseases</title><addtitle>Ann Rheum Dis</addtitle><description>ObjectivesTo study the responsiveness of a combined power Doppler and greyscale ultrasound (PDUS) score for assessing synovitis in biologic-naïve patients with rheumatoid arthritis (RA) starting abatacept plus methotrexate (MTX).MethodsIn this open-label, multicentre, single-arm study, patients with RA (MTX inadequate responders) received intravenous abatacept (∼10 mg/kg) plus MTX for 24 weeks. A composite PDUS synovitis score, developed by the Outcome Measures in Rheumatology–European League Against Rheumatism (OMERACT–EULAR)-Ultrasound Task Force, was used to evaluate individual joints. The maximal score of each joint was added into a Global OMERACT–EULAR Synovitis Score (GLOESS) for bilateral metacarpophalangeal joints (MCPs) 2–5 (primary objective). The value of GLOESS containing other joint sets was explored, along with clinical efficacy.ResultsEighty-nine patients completed the 24-week treatment period. The earliest PDUS sign of improvement in synovitis was at week 1 (mean change in GLOESS (MCPs 2–5): −0.7 (95% CIs −1.2 to −0.1)), with continuous improvement to week 24. Early improvement was observed in the component scores (power Doppler signal at week 1, synovial hyperplasia at week 2, joint effusion at week 4). Comparable changes were observed for 22 paired joints and minimal joint subsets. Mean Disease Activity Score 28 (C reactive protein) was significantly reduced from weeks 1 to 24, reaching clinical meaningful improvement (change ≥1.2) at week 8.ConclusionsIn this first international prospective study, the composite PDUS score is responsive to abatacept. GLOESS demonstrated the rapid onset of action of abatacept, regardless of the number of joints examined. Ultrasound is an objective tool to monitor patients with RA under treatment.Trial registration numberNCT00767325.</description><subject>Abatacept - administration & dosage</subject><subject>Adult</subject><subject>Aged</subject><subject>Antirheumatic Agents - administration & dosage</subject><subject>Arthritis, Rheumatoid - complications</subject><subject>Arthritis, Rheumatoid - diagnostic imaging</subject><subject>Arthritis, Rheumatoid - drug therapy</subject><subject>Biomarkers - analysis</subject><subject>Bones</subject><subject>C-reactive protein</subject><subject>Clinical and Epidemiological Research</subject><subject>Clinical medicine</subject><subject>Doppler effect</subject><subject>Drug dosages</subject><subject>Drug Therapy, Combination</subject><subject>Effusion</subject><subject>Europe</subject><subject>Female</subject><subject>Humans</subject><subject>Hyperplasia</subject><subject>Immunology</subject><subject>Intravenous administration</subject><subject>Joint diseases</subject><subject>Joints - diagnostic imaging</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Methotrexate</subject><subject>Methotrexate - administration & dosage</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Rheumatism</subject><subject>Rheumatoid arthritis</subject><subject>Rheumatology</subject><subject>Severity of Illness Index</subject><subject>Synovitis</subject><subject>Synovitis - diagnostic imaging</subject><subject>Synovitis - drug therapy</subject><subject>Synovitis - etiology</subject><subject>Treatment Outcome</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography, Doppler - methods</subject><subject>Ultrasound</subject><issn>0003-4967</issn><issn>1468-2060</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNks9u1DAQxi0EomXhFcASFzgs2E4cxxwqrapCK61Exb-rNdlMmiyJndpOYR-M98NhS9X21Iut8fzm83j8EfKKs3ecZ8V7sNa3OA11F5aCcZkWpZh-RA55XpQpKthjcsgYy5a5LtQBeRbCNoWs5OVTciAKqRlX-SH58wP6Calr6NRHD8FZd-FhbHcUAgU6gP-Jfk4j-H5HPYbR2YA0OgoVRNjgGGln6QixQxsD_dXFlv7rDaLrago-tr6LXVKzKbIJhhovJ4h4R23A2Lro8XdKfJgzqZ9AG-8GGlukq_PzL6uzryc0xKnePSdPGugDvrjeF-T7x5Nvx6fL9edPZ8er9bKSUsal5DXkipVSioxhWXLUtW5AsLyqKlYrwUELxXINIoMGORZKSZE3bJPLXLI8W5Cjve44VQPWm_RCD70ZfZcGszMOOnM3Y7vWXLgrI1lWCF4kgbd7gfZe2elqbeYzJvJ0KVNXPLFvri_z7nLCEM3QhQ32PVh0UzC8FEpzXersASgvs0yr9P8L8voeunWTt2lqs6DUSspSJErtqY13IXhsbprlzMyOM7ccZ2bHmb3jUuXL2yO6qftvsQSIPVAN2wer_gWb7Oh3</recordid><startdate>20161001</startdate><enddate>20161001</enddate><creator>D'Agostino, 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of ultrasonography as a marker of early response to abatacept in patients with rheumatoid arthritis and an inadequate response to methotrexate: results from the APPRAISE study</title><author>D'Agostino, Maria-Antonietta ; Wakefield, Richard J ; Berner-Hammer, Hilde ; Vittecoq, Olivier ; Filippou, Georgios ; Balint, Peter ; Möller, Ingrid ; Iagnocco, Annamaria ; Naredo, Esperanza ; Østergaard, Mikkel ; Boers, Maarten ; Gaillez, Corine ; Van Holder, Karina ; Le Bars, Manuela</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b555t-51da470855230e881e9d9fa204bbb0d721a927049a23afe1e677524f0c4545043</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Abatacept - administration & dosage</topic><topic>Adult</topic><topic>Aged</topic><topic>Antirheumatic Agents - administration & dosage</topic><topic>Arthritis, Rheumatoid - complications</topic><topic>Arthritis, Rheumatoid - diagnostic imaging</topic><topic>Arthritis, Rheumatoid - drug therapy</topic><topic>Biomarkers - analysis</topic><topic>Bones</topic><topic>C-reactive protein</topic><topic>Clinical and Epidemiological Research</topic><topic>Clinical medicine</topic><topic>Doppler effect</topic><topic>Drug dosages</topic><topic>Drug Therapy, Combination</topic><topic>Effusion</topic><topic>Europe</topic><topic>Female</topic><topic>Humans</topic><topic>Hyperplasia</topic><topic>Immunology</topic><topic>Intravenous administration</topic><topic>Joint diseases</topic><topic>Joints - diagnostic imaging</topic><topic>Life Sciences</topic><topic>Male</topic><topic>Methotrexate</topic><topic>Methotrexate - administration & dosage</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Rheumatism</topic><topic>Rheumatoid arthritis</topic><topic>Rheumatology</topic><topic>Severity of Illness Index</topic><topic>Synovitis</topic><topic>Synovitis - diagnostic imaging</topic><topic>Synovitis - drug therapy</topic><topic>Synovitis - etiology</topic><topic>Treatment Outcome</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography, Doppler - methods</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>D'Agostino, Maria-Antonietta</creatorcontrib><creatorcontrib>Wakefield, Richard J</creatorcontrib><creatorcontrib>Berner-Hammer, Hilde</creatorcontrib><creatorcontrib>Vittecoq, Olivier</creatorcontrib><creatorcontrib>Filippou, Georgios</creatorcontrib><creatorcontrib>Balint, Peter</creatorcontrib><creatorcontrib>Möller, Ingrid</creatorcontrib><creatorcontrib>Iagnocco, Annamaria</creatorcontrib><creatorcontrib>Naredo, Esperanza</creatorcontrib><creatorcontrib>Østergaard, Mikkel</creatorcontrib><creatorcontrib>Boers, Maarten</creatorcontrib><creatorcontrib>Gaillez, Corine</creatorcontrib><creatorcontrib>Van 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Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of the rheumatic diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>D'Agostino, Maria-Antonietta</au><au>Wakefield, Richard J</au><au>Berner-Hammer, Hilde</au><au>Vittecoq, Olivier</au><au>Filippou, Georgios</au><au>Balint, Peter</au><au>Möller, Ingrid</au><au>Iagnocco, Annamaria</au><au>Naredo, Esperanza</au><au>Østergaard, Mikkel</au><au>Boers, Maarten</au><au>Gaillez, Corine</au><au>Van Holder, Karina</au><au>Le Bars, Manuela</au><aucorp>OMERACT-EULAR-Ultrasound Task Force</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Value of ultrasonography as a marker of early response to abatacept in patients with rheumatoid arthritis and an inadequate response to methotrexate: results from the APPRAISE study</atitle><jtitle>Annals of the rheumatic diseases</jtitle><addtitle>Ann Rheum Dis</addtitle><date>2016-10-01</date><risdate>2016</risdate><volume>75</volume><issue>10</issue><spage>1763</spage><epage>1769</epage><pages>1763-1769</pages><issn>0003-4967</issn><eissn>1468-2060</eissn><abstract>ObjectivesTo study the responsiveness of a combined power Doppler and greyscale ultrasound (PDUS) score for assessing synovitis in biologic-naïve patients with rheumatoid arthritis (RA) starting abatacept plus methotrexate (MTX).MethodsIn this open-label, multicentre, single-arm study, patients with RA (MTX inadequate responders) received intravenous abatacept (∼10 mg/kg) plus MTX for 24 weeks. A composite PDUS synovitis score, developed by the Outcome Measures in Rheumatology–European League Against Rheumatism (OMERACT–EULAR)-Ultrasound Task Force, was used to evaluate individual joints. The maximal score of each joint was added into a Global OMERACT–EULAR Synovitis Score (GLOESS) for bilateral metacarpophalangeal joints (MCPs) 2–5 (primary objective). The value of GLOESS containing other joint sets was explored, along with clinical efficacy.ResultsEighty-nine patients completed the 24-week treatment period. The earliest PDUS sign of improvement in synovitis was at week 1 (mean change in GLOESS (MCPs 2–5): −0.7 (95% CIs −1.2 to −0.1)), with continuous improvement to week 24. Early improvement was observed in the component scores (power Doppler signal at week 1, synovial hyperplasia at week 2, joint effusion at week 4). Comparable changes were observed for 22 paired joints and minimal joint subsets. Mean Disease Activity Score 28 (C reactive protein) was significantly reduced from weeks 1 to 24, reaching clinical meaningful improvement (change ≥1.2) at week 8.ConclusionsIn this first international prospective study, the composite PDUS score is responsive to abatacept. GLOESS demonstrated the rapid onset of action of abatacept, regardless of the number of joints examined. Ultrasound is an objective tool to monitor patients with RA under treatment.Trial registration numberNCT00767325.</abstract><cop>England</cop><pub>Elsevier Limited</pub><pmid>26590174</pmid><doi>10.1136/annrheumdis-2015-207709</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-5080-4790</orcidid><orcidid>https://orcid.org/0000-0002-5025-0214</orcidid><orcidid>https://orcid.org/0000-0001-5528-8070</orcidid><orcidid>https://orcid.org/0000-0001-5757-074X</orcidid><orcidid>https://orcid.org/0000-0001-7432-847X</orcidid><orcidid>https://orcid.org/0000-0002-1647-2083</orcidid><orcidid>https://orcid.org/0000-0002-3708-1460</orcidid><orcidid>https://orcid.org/0000-0002-4293-8596</orcidid><orcidid>https://orcid.org/0000-0002-6976-643X</orcidid><orcidid>https://orcid.org/0000-0003-1177-9497</orcidid><orcidid>https://orcid.org/0000-0001-5959-9183</orcidid><orcidid>https://orcid.org/0000-0001-8793-3644</orcidid><orcidid>https://orcid.org/0000-0003-4002-1861</orcidid><orcidid>https://orcid.org/0000-0002-4244-5417</orcidid><orcidid>https://orcid.org/0000-0001-9349-0720</orcidid><orcidid>https://orcid.org/0009-0009-9738-4066</orcidid><orcidid>https://orcid.org/0000-0002-9815-2138</orcidid><orcidid>https://orcid.org/0000-0002-1095-3492</orcidid><orcidid>https://orcid.org/0000-0001-5592-724X</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0003-4967 |
| ispartof | Annals of the rheumatic diseases, 2016-10, Vol.75 (10), p.1763-1769 |
| issn | 0003-4967 1468-2060 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5036216 |
| source | MEDLINE; BMJ Journals - NESLi2 |
| subjects | Abatacept - administration & dosage Adult Aged Antirheumatic Agents - administration & dosage Arthritis, Rheumatoid - complications Arthritis, Rheumatoid - diagnostic imaging Arthritis, Rheumatoid - drug therapy Biomarkers - analysis Bones C-reactive protein Clinical and Epidemiological Research Clinical medicine Doppler effect Drug dosages Drug Therapy, Combination Effusion Europe Female Humans Hyperplasia Immunology Intravenous administration Joint diseases Joints - diagnostic imaging Life Sciences Male Methotrexate Methotrexate - administration & dosage Middle Aged Patients Predictive Value of Tests Prospective Studies Rheumatism Rheumatoid arthritis Rheumatology Severity of Illness Index Synovitis Synovitis - diagnostic imaging Synovitis - drug therapy Synovitis - etiology Treatment Outcome Ultrasonic imaging Ultrasonography, Doppler - methods Ultrasound |
| title | Value of ultrasonography as a marker of early response to abatacept in patients with rheumatoid arthritis and an inadequate response to methotrexate: results from the APPRAISE study |
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