The clinical utility of musculoskeletal ultrasound for disease activity evaluation and therapeutic response prediction in rheumatoid arthritis patients: A narrative review

Rheumatoid arthritis (RA) is characterized by persistent synovitis and joint/bone destruction. There is an unmet need to predict the therapeutic response to disease-modifying anti-rheumatic drugs (DMARDs) and achieve a treat-to-target goal. Musculoskeletal ultrasound (MSUS) is widely used to identif...

Full description

Bibliographic Details
Main Authors: Chia-Ching Chen, Der-Yuan Chen
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-01-01
Series:Journal of Medical Ultrasound
Subjects:
Online Access:http://www.jmuonline.org/article.asp?issn=0929-6441;year=2023;volume=31;issue=4;spage=275;epage=281;aulast=Chen
_version_ 1797222410450108416
author Chia-Ching Chen
Der-Yuan Chen
author_facet Chia-Ching Chen
Der-Yuan Chen
author_sort Chia-Ching Chen
collection DOAJ
description Rheumatoid arthritis (RA) is characterized by persistent synovitis and joint/bone destruction. There is an unmet need to predict the therapeutic response to disease-modifying anti-rheumatic drugs (DMARDs) and achieve a treat-to-target goal. Musculoskeletal ultrasound (MSUS) is widely used to identify structural change and assess therapeutic response in RA. This review aims to summarize the available evidence regarding the clinical application of MSUS in evaluating disease activity and predicting therapeutic responses to DMARDs. We searched the MEDLINE database using the PubMed interface and reviewed English-language literature from 2000 to 2022. This review focuses on the updated role of MSUS in assessing disease activity and predicting therapeutic responses to DMARDs in RA patients. MSUS is now widely applied to identify articular structural change and assess the disease activity of RA. Combined use of gray scale and power Doppler MSUS is also superior to clinical assessment and laboratory examination in evaluating disease activity of RA. With portable use, good viability, and high sensitivity to articular inflammation, MSUS would be useful in assessing therapeutic response to biologic/targeted synthetic DMARDs (b/tsDMARDs) in RA patients. Given MSUS could also detect subclinical inflammation in a substantial proportion of RA patients with clinical remission, it is recommended to assess b/tsDMARDs-treated RA patients who have achieved low disease activity or remission. Although substantial literature data have revealed clinical utility of MSUS for monitoring disease activity and evaluating therapeutic response in RA patients, the evidence regarding its predictive value for the effectiveness of b/tsDMARDs is limited.
first_indexed 2024-04-24T13:20:53Z
format Article
id doaj.art-e26610e4c7374e3e9af954a66f8dde9e
institution Directory Open Access Journal
issn 0929-6441
2212-1552
language English
last_indexed 2024-04-24T13:20:53Z
publishDate 2023-01-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Journal of Medical Ultrasound
spelling doaj.art-e26610e4c7374e3e9af954a66f8dde9e2024-04-04T16:16:14ZengWolters Kluwer Medknow PublicationsJournal of Medical Ultrasound0929-64412212-15522023-01-0131427528110.4103/jmu.jmu_126_22The clinical utility of musculoskeletal ultrasound for disease activity evaluation and therapeutic response prediction in rheumatoid arthritis patients: A narrative reviewChia-Ching ChenDer-Yuan ChenRheumatoid arthritis (RA) is characterized by persistent synovitis and joint/bone destruction. There is an unmet need to predict the therapeutic response to disease-modifying anti-rheumatic drugs (DMARDs) and achieve a treat-to-target goal. Musculoskeletal ultrasound (MSUS) is widely used to identify structural change and assess therapeutic response in RA. This review aims to summarize the available evidence regarding the clinical application of MSUS in evaluating disease activity and predicting therapeutic responses to DMARDs. We searched the MEDLINE database using the PubMed interface and reviewed English-language literature from 2000 to 2022. This review focuses on the updated role of MSUS in assessing disease activity and predicting therapeutic responses to DMARDs in RA patients. MSUS is now widely applied to identify articular structural change and assess the disease activity of RA. Combined use of gray scale and power Doppler MSUS is also superior to clinical assessment and laboratory examination in evaluating disease activity of RA. With portable use, good viability, and high sensitivity to articular inflammation, MSUS would be useful in assessing therapeutic response to biologic/targeted synthetic DMARDs (b/tsDMARDs) in RA patients. Given MSUS could also detect subclinical inflammation in a substantial proportion of RA patients with clinical remission, it is recommended to assess b/tsDMARDs-treated RA patients who have achieved low disease activity or remission. Although substantial literature data have revealed clinical utility of MSUS for monitoring disease activity and evaluating therapeutic response in RA patients, the evidence regarding its predictive value for the effectiveness of b/tsDMARDs is limited.http://www.jmuonline.org/article.asp?issn=0929-6441;year=2023;volume=31;issue=4;spage=275;epage=281;aulast=Chendisease activitydisease-modifying antirheumatic drugsrheumatoid arthritistherapeutic responseultrasound
spellingShingle Chia-Ching Chen
Der-Yuan Chen
The clinical utility of musculoskeletal ultrasound for disease activity evaluation and therapeutic response prediction in rheumatoid arthritis patients: A narrative review
Journal of Medical Ultrasound
disease activity
disease-modifying antirheumatic drugs
rheumatoid arthritis
therapeutic response
ultrasound
title The clinical utility of musculoskeletal ultrasound for disease activity evaluation and therapeutic response prediction in rheumatoid arthritis patients: A narrative review
title_full The clinical utility of musculoskeletal ultrasound for disease activity evaluation and therapeutic response prediction in rheumatoid arthritis patients: A narrative review
title_fullStr The clinical utility of musculoskeletal ultrasound for disease activity evaluation and therapeutic response prediction in rheumatoid arthritis patients: A narrative review
title_full_unstemmed The clinical utility of musculoskeletal ultrasound for disease activity evaluation and therapeutic response prediction in rheumatoid arthritis patients: A narrative review
title_short The clinical utility of musculoskeletal ultrasound for disease activity evaluation and therapeutic response prediction in rheumatoid arthritis patients: A narrative review
title_sort clinical utility of musculoskeletal ultrasound for disease activity evaluation and therapeutic response prediction in rheumatoid arthritis patients a narrative review
topic disease activity
disease-modifying antirheumatic drugs
rheumatoid arthritis
therapeutic response
ultrasound
url http://www.jmuonline.org/article.asp?issn=0929-6441;year=2023;volume=31;issue=4;spage=275;epage=281;aulast=Chen
work_keys_str_mv AT chiachingchen theclinicalutilityofmusculoskeletalultrasoundfordiseaseactivityevaluationandtherapeuticresponsepredictioninrheumatoidarthritispatientsanarrativereview
AT deryuanchen theclinicalutilityofmusculoskeletalultrasoundfordiseaseactivityevaluationandtherapeuticresponsepredictioninrheumatoidarthritispatientsanarrativereview
AT chiachingchen clinicalutilityofmusculoskeletalultrasoundfordiseaseactivityevaluationandtherapeuticresponsepredictioninrheumatoidarthritispatientsanarrativereview
AT deryuanchen clinicalutilityofmusculoskeletalultrasoundfordiseaseactivityevaluationandtherapeuticresponsepredictioninrheumatoidarthritispatientsanarrativereview