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Clinical and Ultrasonographic Monitoring of Response to Adalimumab Treatment in Rheumatoid Arthritis
ANNAMARIA IAGNOCCO, EMILIO FILIPPUCCI, CHIARA PERELLA, FULVIA CECCARELLI, EMANUELE CASSARÀ, CRISTIANO ALESSANDRI, EMANUELA SABATINI, WALTER GRASSI, and GUIDO VALESINI
ABSTRACT. Methods. Twenty-five patients with RA were commenced on adalimumab therapy. Before the beginning of the therapy (Time 0) and after 3 (T1), 12 (T2), and 24 (T3) months we evaluated erythrocyte sedimentation rate, C-reactive protein, physician and patient visual analog scale for disease activity, number of tender and swollen joints, Health Assessment Questionnaire, and Disease Activity Score in 28 joints. In addition, musculoskeletal ultrasound (US) was performed bilaterally in the 2nd and 5th metacarpophalangeal, 3rd interphalangeal, wrist, and knee joints and in the tendon sheaths and bursae of those areas. A semiquantitative score (0–3) was used to indicate the presence of a localized inflammatory process and/or structural damage. The summed total was used as an indicator of global change in each joint (single joint score). The sum of the single joint scores was used as an indicator of overall polyarticular involvement in each patient (total score). Results. Patients who did not submit to the planned examinations strictly on time were excluded from the study. Then 25 patients were examined at T0 and T1, 20 at T2, and 9 at T3. All clinical and laboratory measures as well as the US scores were significantly reduced during the followup. Conclusion. A positive response to treatment with adalimumab was demonstrated by clinical, laboratory, and US evaluation by both short- and longterm followup. (First Release Nov 15 2007; J Rheumatol 2008;35:35-40) Key Indexing Terms:
BIOLOGICAL THERAPY
From the Rheumatology Unit, Sapienza Università di Roma, Rome; and the Rheumatology Department, Università Politecnica delle Marche, Ancona, Italy. A. Iagnocco, MD, Assistant Professor; C. Perella, MD; F. Ceccarelli, MD, Research Fellow; E. Cassarà, MD; C. Alessandri, MD, Research Fellow; E. Sabatini, MD; G. Valesini, MD, PhD, Professor, Rheumatology Unit, Sapienza Università di Roma; E. Filippucci, MD, Assistant Professor; W. Grassi, MD, PhD, Professor, Rheumatology Department, Università Politecnica delle Marche. Address reprint requests to Dr. A. Iagnocco, Dipartimento Clinica e Terapia Medica Applicata, Cattedra di Reumatologia, Sapienza Università di Roma, Viale del Policlinico 155, Roma, 00161, Italy. E-mail: annamaria.iagnocco@uniroma1.it Accepted for publication August 23, 2007. |