Doppler sonographic evaluation of infliximab therapy for rheumatoid arthritis

To the Editor: In a previous issue of Modern Rheumatology, we demonstrated the usefulness of sonographic evaluation for determining the therapeutic effect of infliximab in six patients with rheumatoid arthritis (RA). Both color flow signals and resistance index (RI) (vascular resistance) in the knee joints of patients demonstrated significant improvements on Doppler sonography (P < 0.05 each) after three injections at the 6-week evaluation of infliximab treatment. The present study of 12 RA patients (including the previously reported six patients) treated using infliximab confirms the previous results. Furthermore, more significant indications of improvement were obtained in several clinico-sonographic findings compared with the previous study. All 12 RA patients satisfied the American College of Rheumatology (ACR) revised 1987 criteria for RA and received pharmacotherapy in accordance with the official Japanese guidelines for infliximab treatment of RA. Patients were injected with infliximab on days 0, 14, and 42 at a dose of 3mg/kg per injection. Clinical and sonographic evaluations were per-