{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T07:10:56Z","timestamp":1763968256662,"version":"3.37.3"},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,10,12]],"date-time":"2017-10-12T00:00:00Z","timestamp":1507766400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The use of biological agents has revolutionized the treatment of rheumatoid arthritis (<jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>). However, details of serial synovial changes in imaging evaluation are unclear. Using power Doppler (<jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>) ultrasound, this study aimed to evaluate the comparative efficacy of biologicals for patients with refractory <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>, with the hope that these findings could aid in clinical decision making.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> who received abatacept, adalimumab or tocilizumab therapy were enrolled. All underwent gray scale synovial hypertrophy and <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> assessments of the dominant wrist (dorsal aspect) at baseline and at 1, 3 and 6 months after therapy. A generalized estimating equation model was used to compare efficacy among the three drugs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 103 patients enrolled, 32 received adalimumab, 38 abatacept and 33 tocilizumab. There were no significant differences in age or sex among the three groups. All had a treatment response according to gray scale (<jats:italic>P<\/jats:italic> = 0.000) and <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> (<jats:italic>P<\/jats:italic> = 0.001) synovitis scores. The tocilizumab group had a significantly lower synovial hypertrophy score at 6 months (<jats:italic>P<\/jats:italic> = 0.006), and the adalimumab group also had a lower score although without statistical significance (<jats:italic>P<\/jats:italic> = 0.043). The adalimumab group had a lower <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> score than the other two groups (<jats:italic>P<\/jats:italic> &lt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In a 6\u2010month head\u2010to\u2010head comparison of patients with <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>, tocilizumab and adalimumab had a greater effect on reducing synovial hypertrophy, while adalimumab had a greater effect in controlling inflammation in <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1756-185x.13188","type":"journal-article","created":{"date-parts":[[2017,10,12]],"date-time":"2017-10-12T06:16:42Z","timestamp":1507789002000},"page":"1695-1700","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Generalized estimating equation model to compare drug effects on 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