Power Doppler in hand joints predicts therapeutic failure in treatment-naive women with early rheumatoid arthritis: A prospective study

Objective:   This study aimed to determine whether ultrasound measurements of the hands could predict treatment failure in treatment-naive women with early rheumatoid arthritis. Method:   In a prospective case-control study, 48 women underwent blind assessments four times over 48-w...

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Autores: Luz, Karine Rodrigues da, Natour, Jamil, Pinheiro, Marcelo de Medeiros, Petterle, Giovanna S., Santos, Marla Francisca dos, Fernandes, Artur da Rocha Correa, Furtado, Rita Nely Vilar
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:Brasil
Institución:Universidade de São Paulo (USP)
Repositorio:Clinics
Idioma:inglés
OAI Identifier:oai:revistas.usp.br:article/240605
Acceso en línea:https://revistas.usp.br/clinics/article/view/240605
Access Level:acceso abierto
Palabra clave:Rheumatoid arthritis
Diagnostic imaging
Ultrasonography
Hand joints
Drug therapy
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spelling Power Doppler in hand joints predicts therapeutic failure in treatment-naive women with early rheumatoid arthritis: A prospective studyRheumatoid arthritisDiagnostic imagingUltrasonographyHand jointsDrug therapy Objective:   This study aimed to determine whether ultrasound measurements of the hands could predict treatment failure in treatment-naive women with early rheumatoid arthritis. Method:   In a prospective case-control study, 48 women underwent blind assessments four times over 48-weeks, considering three failure stages: failure 1 (methotrexate), failure 2 (leflunomide), and failure 3 (adalimumab). Bilateral ultrasound exams evaluated wrist, 2nd, and 3rd Metacarpophalangeal Joints (MCPs), and Proximal Interphalangeal Joints (PIPs) for inflammatory indicators (synovial and tenosynovial proliferation using grayscale and Power Doppler [PD]) and joint damage (bone erosion and cartilage damage). Results:   The study involved 48 women, aged 47.7 ± 11.6 years, with an average disease duration of 7.5 ± 3.5 months. Of these, 41 (85.41 %) experienced failure 1, 25 (52 %) experienced failure 2, and 5 (10.5%) experienced failure 3. Predictors for failure 1 included PD/Q10 total score > 2.5 (OR = 18.00), PD/SQ10 total score > 5.0 (OR = 23.2), PD/Q MCP score > 1.5 (OR = 14.58), and PD/SQ MCP score > 3.0 (OR = 35). For failure 2, predictors encompassed PD/Q10 total score > 4.5 (OR = 4.81), PD/SQ10 total score > 9.5 (OR = 4.81), PD/Q MCP score > 2.5 (OR = 4.92), PD/SQ MCP score >5.0 (OR = 6.22), and PD/Q PIP score > 1.5 (OR = 6.66). In relation to failure 3, a PD/Q wrist score > 2.5 (AUC = 0.79; p = 0.035) was indicative. Conclusions:   Power Doppler proved to be a predictive indicator for treatment failure in early rheumatoid arthritis among treatment-naive women. It emerged as a predictor for both the initial and 2nd DMARD treatments, as well as the 1st immunobiological treatment, based on hand joint assessments. Trial registration: Clinical trials.gov NCT04752748.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2025-01-27info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://revistas.usp.br/clinics/article/view/24060510.1590/Clinics; Vol. 80 (2025); 100593Clinics; v. 80 (2025); 100593Clinics; Vol. 80 (2025); 1005931980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://revistas.usp.br/clinics/article/view/240605/216972Copyright (c) 2025 Clinicsinfo:eu-repo/semantics/openAccessLuz, Karine Rodrigues daNatour, JamilPinheiro, Marcelo de MedeirosPetterle, Giovanna S.Santos, Marla Francisca dosFernandes, Artur da Rocha CorreaFurtado, Rita Nely Vilar2025-09-11T14:47:08Zoai:revistas.usp.br:article/240605Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2025-09-11T14:47:08Clinics - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Power Doppler in hand joints predicts therapeutic failure in treatment-naive women with early rheumatoid arthritis: A prospective study
title Power Doppler in hand joints predicts therapeutic failure in treatment-naive women with early rheumatoid arthritis: A prospective study
spellingShingle Power Doppler in hand joints predicts therapeutic failure in treatment-naive women with early rheumatoid arthritis: A prospective study
Luz, Karine Rodrigues da
Rheumatoid arthritis
Diagnostic imaging
Ultrasonography
Hand joints
Drug therapy
title_short Power Doppler in hand joints predicts therapeutic failure in treatment-naive women with early rheumatoid arthritis: A prospective study
title_full Power Doppler in hand joints predicts therapeutic failure in treatment-naive women with early rheumatoid arthritis: A prospective study
title_fullStr Power Doppler in hand joints predicts therapeutic failure in treatment-naive women with early rheumatoid arthritis: A prospective study
title_full_unstemmed Power Doppler in hand joints predicts therapeutic failure in treatment-naive women with early rheumatoid arthritis: A prospective study
title_sort Power Doppler in hand joints predicts therapeutic failure in treatment-naive women with early rheumatoid arthritis: A prospective study
dc.creator.none.fl_str_mv Luz, Karine Rodrigues da
Natour, Jamil
Pinheiro, Marcelo de Medeiros
Petterle, Giovanna S.
Santos, Marla Francisca dos
Fernandes, Artur da Rocha Correa
Furtado, Rita Nely Vilar
author Luz, Karine Rodrigues da
author_facet Luz, Karine Rodrigues da
Natour, Jamil
Pinheiro, Marcelo de Medeiros
Petterle, Giovanna S.
Santos, Marla Francisca dos
Fernandes, Artur da Rocha Correa
Furtado, Rita Nely Vilar
author_role author
author2 Natour, Jamil
Pinheiro, Marcelo de Medeiros
Petterle, Giovanna S.
Santos, Marla Francisca dos
Fernandes, Artur da Rocha Correa
Furtado, Rita Nely Vilar
author2_role author
author
author
author
author
author
dc.subject.por.fl_str_mv Rheumatoid arthritis
Diagnostic imaging
Ultrasonography
Hand joints
Drug therapy
topic Rheumatoid arthritis
Diagnostic imaging
Ultrasonography
Hand joints
Drug therapy
description Objective:   This study aimed to determine whether ultrasound measurements of the hands could predict treatment failure in treatment-naive women with early rheumatoid arthritis. Method:   In a prospective case-control study, 48 women underwent blind assessments four times over 48-weeks, considering three failure stages: failure 1 (methotrexate), failure 2 (leflunomide), and failure 3 (adalimumab). Bilateral ultrasound exams evaluated wrist, 2nd, and 3rd Metacarpophalangeal Joints (MCPs), and Proximal Interphalangeal Joints (PIPs) for inflammatory indicators (synovial and tenosynovial proliferation using grayscale and Power Doppler [PD]) and joint damage (bone erosion and cartilage damage). Results:   The study involved 48 women, aged 47.7 ± 11.6 years, with an average disease duration of 7.5 ± 3.5 months. Of these, 41 (85.41 %) experienced failure 1, 25 (52 %) experienced failure 2, and 5 (10.5%) experienced failure 3. Predictors for failure 1 included PD/Q10 total score > 2.5 (OR = 18.00), PD/SQ10 total score > 5.0 (OR = 23.2), PD/Q MCP score > 1.5 (OR = 14.58), and PD/SQ MCP score > 3.0 (OR = 35). For failure 2, predictors encompassed PD/Q10 total score > 4.5 (OR = 4.81), PD/SQ10 total score > 9.5 (OR = 4.81), PD/Q MCP score > 2.5 (OR = 4.92), PD/SQ MCP score >5.0 (OR = 6.22), and PD/Q PIP score > 1.5 (OR = 6.66). In relation to failure 3, a PD/Q wrist score > 2.5 (AUC = 0.79; p = 0.035) was indicative. Conclusions:   Power Doppler proved to be a predictive indicator for treatment failure in early rheumatoid arthritis among treatment-naive women. It emerged as a predictor for both the initial and 2nd DMARD treatments, as well as the 1st immunobiological treatment, based on hand joint assessments. Trial registration: Clinical trials.gov NCT04752748.
publishDate 2025
dc.date.none.fl_str_mv 2025-01-27
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://revistas.usp.br/clinics/article/view/240605
10.1590/
url https://revistas.usp.br/clinics/article/view/240605
identifier_str_mv 10.1590/
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://revistas.usp.br/clinics/article/view/240605/216972
dc.rights.driver.fl_str_mv Copyright (c) 2025 Clinics
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2025 Clinics
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
publisher.none.fl_str_mv Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
dc.source.none.fl_str_mv Clinics; Vol. 80 (2025); 100593
Clinics; v. 80 (2025); 100593
Clinics; Vol. 80 (2025); 100593
1980-5322
1807-5932
reponame:Clinics
instname:Universidade de São Paulo (USP)
instacron:USP
instname_str Universidade de São Paulo (USP)
instacron_str USP
institution USP
reponame_str Clinics
collection Clinics
repository.name.fl_str_mv Clinics - Universidade de São Paulo (USP)
repository.mail.fl_str_mv ||clinics@hc.fm.usp.br
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