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Decrease in articular hypoxia and synovial blood flow at early time points following infliximab and etanercept
Benjamin A Fisher1, Philippe Donatien2, Andrew Filer1
1Rheumatology Research Group, University of Birmingham, UK.
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.
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