Evidence map›Paper›PMID 32803573›Full record

ArticleClinical rheumatology2021

Sentinel joint scoring in rheumatoid arthritis: an individualized power Doppler assessment strategy.

Daniel Kuo, Nicolette T Morris, Gurjit S Kaeley, Ami Ben-Artzi, Jenny Brook, David A Elashoff, Veena K Ranganath

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

Article in Clinical rheumatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01717859 (Musculoskeletal Ultrasound in Predicting Early Dose Titration With Tocilizumab), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.7field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01717859 phase4completednot on this map

Musculoskeletal Ultrasound in Predicting Early Dose Titration With Tocilizumab

TypeinterventionalSponsorUniversity of California, Los AngelesRan2014 to 2017Enrolled74ConditionsRheumatoid ArthritisArmsTocilizumab
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Daniel Kuo *David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Nicolette T Morris *David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Gurjit S KaeleyCollege of Medicine, University of Florida, Jacksonville, FL, USA.
Ami Ben-ArtziDivision of Rheumatology, Cedars Sinai Medical Center, Los Angeles, CA, USA.
Jenny BrookDavid Geffen School of Medicine, University of California, Los Angeles, CA, USA.
David A ElashoffDavid Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Veena K RanganathDavid Geffen School of Medicine, University of California, Los Angeles, CA, USA. VRanganath@mednet.ucla.edu.ORCID https://orcid.org/0000-0003-3417-9478
University of California, Los Angeles · USCedars-Sinai Medical Center · USUniversity of Florida · US

Funding

Genentech ML28542
6 · The paper itself

Abstract

objectiveMusculoskeletal ultrasound quantifies the total synovial inflammatory burden in rheumatoid arthritis (RA) but is time consuming when scanning numerous joints. This study evaluated a novel patient-centered method for constructing a longitudinal ultrasound score in RA patients.

methodsFifty-four RA patients starting intravenous tocilizumab were evaluated with power Doppler ultrasound (PDUS) of 34 joints and DAS28-ESR was assessed at baseline and weeks 4, 12, 16, and 24. The sentinel joint score (SJS) was derived from the reduced subset of joints with PDUS ≥ 1 at baseline. Total PDUS (tPDUS) score and US7 were also calculated. Changes in tPDUS and SJS were correlated. Effect sizes were calculated for tPDUS, SJS, and US7. The proportion of "flipped" joints without baseline PDUS signal that later developed PDUS signal was estimated.

resultsAt baseline, 1236/1829 joints scanned (67.5%) did not have PDUS signal. The proportion of "flipped" joints at 24 weeks was 5.6% for ≥ 1, 2.9% for ≥ 2, and 1.0% for = 3 PD. tPDUS and SJS scores were highly correlated (r = 0.91 to 0.97). Overall the effect sizes for tPDUS, SJS, and US7 increased over 24 weeks, where SJS was the highest (SJS 1.00 4-week, 1.07 12-week, 1.26 24-week) and tPDUS and US7 were comparable (tPDUS 0.32 4-week, 0.52 12-week, 0.84 24-week; US7 0.23 4-week, 0.52 12-week, 0.74 24-week).

conclusionIn RA patients starting a biologic, scanning only joints with baseline PDUS signal can substantially reduce the number of joints requiring follow-up scanning by 67.5% and improves feasibility. "Flipped" joints are infrequently seen after starting therapy.

trial registrationClinicalTrials.gov NCT01717859 Key messages • Only a small percent of joints develop power Doppler signal after baseline scanning. • Changes in the SJS correlate well with changes in clinical activity measured by DAS28-ESR over time. • The SJS effect size is higher than total PDUS and US7 scores, and may improve examination feasibility.

Indexed as

Antirheumatic AgentsArthritis, RheumatoidSynovitisHumansSeverity of Illness IndexUltrasonographyUltrasonography, DopplerAntirheumatic AgentsOutcome measuresResponseRheumatoid arthritisUltrasonography

Identifiers

PMID32803573
OpenAlexW3049408860

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.