In the study, researchers found that RA patients with negative ACPA were the subgroup with the highest chance to maintain remission after disease-modifying anti-rheumatic drug tapering.
A study out of Spain found that Power Doppler ultrasound findings can also help shed light on which patients will stay in remission after their drug regimen of biologic therapy is reduced. Synovitis detected by Power Doppler was the strongest predictor of failed biologic therapy tapering in RA patients in sustained clinical remission.4
At Dr. Schett’s center, researchers have looked at the predictive value of multi-biomarker disease activity (MBDA) score and indication of residual disease activity for patients in the RETRO study. They have found that coupling those scores with ACPA positivity strengthens the ability to predict remission after biologic therapy dosing is lowered or stopped.
“The initial evidence suggests,” Dr. Schett said, “that ACPA status, presence of Power Doppler–positive lesions in ultrasound and MBDA scores are potential predictors for relapse of disease after tapering their disease-modifying anti-rheumatic drug treatment.”
Thomas R. Collins is a freelance medical writer based in Florida.
References
- Colebatch AN, Edwards CJ, Østergaard M, et al. EULAR recommendations for the use of imaging of the joints in the clinical management of rheumatoid arthritis. Ann Rheum Dis. 2013 Jun;72(6):804–814.
- Wakefield RJ, Green MJ, Marzo-Ortega H, et al. Should oligoarthritis be reclassified? Ultrasound reveals a high prevalence of subclinical disease. Ann Rheum Dis. 2004 Apr;63(4):382–385.
- Haschka J, Englbrecht M, Hueber AJ, et al. Relapse rates in patients with rheumatoid arthritis in stable remission tapering or stopping antirheumatic therapy: Interim results from the prospective randomised controlled RETRO study. Ann Rheum Dis. 2015 Feb 6. pii: annrheumdis-2014-206439. [Epub ahead of print]
- Foltz V, Gandibakhch F, Ethepare F, et al. Power Doppler ultrasound, but not low-field magnetic resonance imaging, predicts relapse and radiographic disease progression in rheumatoid arthritis patients with low levels of disease activity. Arthritis Rheum. 2012 Jan;64(1):67–76.