Decrease in articular hypoxia and synovial blood flow at early time points following infliximab and etanercept treatment in rheumatoid arthritis

Clin Exp Rheumatol. 2016 Nov-Dec;34(6):1072-1076. Epub 2016 Sep 8.

Abstract

Objectives: An important feature of rheumatoid arthritis (RA) is hypoxia-driven synovial angiogenesis, but the relationship between change in vascularity, as measured by power Doppler ultrasound (PDUS), and oxygen tensions is unaddressed.

Methods: Metacarpophalangeal (MCP) joint PDUS was assessed in 23 patients with RA, alongside arthroscopic synovitis and oxygen tension measurements, at baseline and 4 weeks after anti-tumour necrosis factor (TNF) inhibitors.

Results: Anti-TNF reduced PDUS scores, which were negatively correlated with rise in oxygen tensions. The latter was related to good EULAR response at week 52.

Conclusions: Anti-TNF results in rapid reduction in synovial blood flow, with a corresponding rise in oxygen tension most marked in EULAR good responders.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Antirheumatic Agents / pharmacology
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Rheumatoid / diagnostic imaging
  • Arthritis, Rheumatoid / drug therapy*
  • Etanercept / pharmacology
  • Etanercept / therapeutic use*
  • Female
  • Humans
  • Hypoxia / diagnostic imaging
  • Hypoxia / drug therapy*
  • Infliximab / pharmacology
  • Infliximab / therapeutic use*
  • Male
  • Metacarpophalangeal Joint / blood supply*
  • Metacarpophalangeal Joint / diagnostic imaging
  • Metacarpophalangeal Joint / drug effects
  • Middle Aged
  • Regional Blood Flow / drug effects*
  • Synovial Membrane / blood supply*
  • Synovial Membrane / diagnostic imaging
  • Synovial Membrane / drug effects
  • Treatment Outcome

Substances

  • Antirheumatic Agents
  • Infliximab
  • Etanercept