Individualized treatment strategy for patients with rheumatoid arthritis based on imaging evaluation

Abstract

Purpose: To study the effect of individualized treatment strategy based on imaging evaluation in patients with rheumatoid arthritis (RA). Methods: Eighty patients with RA of the wrist treated in the Second Affiliated Hospital of Nanjing Medical University, China from January  2018 to December 2022 were assigned to control and study groups. Conventional methods were used for treating control subjects, based  on RA laboratory index results, while the study group received individualized treatment based on RA laboratory index results and results  of imaging evaluation. Before and after treatment, serum levels of rheumatoid factor (RF) and C-reactive protein (CRP) were assayed  using immunoturbidimetry. Erythrocyte sedimentation rate (ESR) was determined by Wei method. Imaging examination - ultrasound or  magnetic resonance imaging (MRI) - was carried out in study group before and after treatment. Disease activity score 28 (DAS28) and  score on the visual analogue scale (VAS) were evaluated before and after treatment, and the curative effect in the two groups was  compared based on curative effect evaluation. Results: In both groups, post-treatment values of RF, CRP and ESR were lower than the corresponding pre-treatment levels, but were significantly smaller in study group (p < 0.05). The DAS28 and VAS scores of the two groups  after treatment were significantly lower (p < 0.05) than the pretreatment levels, but the DAS28 and VAS scores were significantly lower in  study group (p < 0.05). Treatment efficacy in study group (95.0 %) was significantly higher than in control patients (77.5 %, p = 0.0476). The  results of imaging indicators showed significantly reduced post-treatment synovial thickness and joint effusion in study group  patients when compared with control patients (p < 0.01). Conclusion: Individualized treatment strategy for RA patients based on imaging  results enhances curative effectiveness, reduces disease activity, relieves pain, and improves the quality of life of patients.