title: The US7 score is sensitive to change in a large cohort of patients with rheumatoid arthritis over 12 months of therapy.
abstract: OBJECTIVE
  To determine the sensitivity to change of the US7 score among RA patients under various therapies and to analyze the effect of each therapeutic option over 1 year. To estimate predictors for development of destructive bone changes.
  
  
  METHODS
  Musculoskeletal ultrasound (US7 score), DAS28, CRP and ESR were performed in 432 RA patients at baseline and after 3, 6 and 12 months. The cohort was divided into four sub-groups: first-line DMARDs (Group 1; 27.3%), therapy switch: DMARDs to second DMARDs (Group 2; 25.0%), first-line biologic after DMARDs therapy (Group 3; 35.4%) and therapy change from biologic to second biologic (Group 4; 12.3%).
  
  
  RESULTS
  The US7 synovitis and tenosynovitis sum scores in grey-scale (GSUS) and power Doppler ultrasound (PDUS) as well as ESR, CRP decreased significantly (p<0.05) after 12 months in group 1 to 3. Group 1+2 also illustrated a significant change of DAS28 after 1 year (p<0.001). Only in Group 4, the US7 erosion sum score decreased significantly from 4.3 to 3.6 (p=0.008) after 1 year. Predictors capable of forecasting US erosions after one year were: higher score of US7 synovitis (p<0.001), of US7 erosions in GSUS (p<0.001), as well as of DAS28 (p<0.001) at baseline.
  
  
  CONCLUSIONS
  The comparable developments of the US7 score with clinical and laboratory data illustrates its potential to reflect therapeutic response. Therefore, the novel US7 score is sensitive to change. Patients who switched from one biologic to another exhibited a significant decline in erosions after 12 months, while the erosions scores in the other groups were stable.
authors.affiliation: Department of Medicine III, Nephrology and Rheumatology, Universitätsklinikum UKE, Hamburg, Germany. marina.backhaus@charite.de
authors.forename: Tina M
authors.initials: TM
authors.lastname: Backhaus
authors.forename: Sarah
authors.initials: S
authors.lastname: Ohrndorf
authors.forename: Herbert
authors.initials: H
authors.lastname: Kellner
authors.forename: Johannes
authors.initials: J
authors.lastname: Strunk
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hartung
authors.forename: Horst
authors.initials: H
authors.lastname: Sattler
authors.forename: Christof
authors.initials: C
authors.lastname: Iking-Konert
authors.forename: Gerd R
authors.initials: GR
authors.lastname: Burmester
authors.forename: Wolfgang A
authors.initials: WA
authors.lastname: Schmidt
authors.forename: Marina
authors.initials: M
authors.lastname: Backhaus
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D015331:Cohort Studies; D005260:Female; D033023:Foot Joints / Q000000981:diagnostic imaging; D050823:Hand Joints / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013585:Synovitis / Q000000981:diagnostic imaging* / Q000209:etiology; D013717:Tenosynovitis / Q000000981:diagnostic imaging* / Q000209:etiology; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents