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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.


Journal article


Clin Exp Rheumatol

Publication Date





1072 - 1076


Adult, Aged, Antirheumatic Agents, Arthritis, Rheumatoid, Etanercept, Female, Humans, Hypoxia, Infliximab, Male, Metacarpophalangeal Joint, Middle Aged, Regional Blood Flow, Synovial Membrane, Treatment Outcome