GE Healthcare Blog - Cardiology, Oncology, Molecular Imaging

Redefining standards of care in Rheumatoid Arthritis with a targeted ultrasound approach

According to Professor Paul Emery, Arthritis Research UK Professor of Rheumatology and Head of the Musculoskeletal Division, Leeds Instituteof Molecular Medicine, University of Leeds, UK : 

In recent years, the introduction of biological agents and application of the Treat to Target (T2T) approach¹  have made clinical remission an achievable goal for many patients with rheumatoid arthritis (RA). Once remission is attained, it is important to maintain absence of disease activity and flare for as long as possible. Available data suggest that up to 50% of patients in clinical remission may experience a disease flare within 2 years² and that increased power Doppler (PD) ultrasound activity in clinical remission is associated with disease flare,³ along with being predictive of longterm structural damage.⁴ 

As such, combining imaging with clinical assessments to monitor RA disease activity may further improve outcomes and help to guide subsequent treatment decisions.

The TURA trial has been designed to assess whether the addition of ultrasound-guided therapy to standard clinical management of RA using T2T principles can further improve outcomes in patients with stable, clinical low disease activity/remission. The primary objective is to determine whether therapy modifications guided by ultrasound findings and DAS28 scores can reduce the level of inflammation assessed by PD ultrasound compared with clinical assessment of DAS28 alone. Other key objectives are to establish whether addition of ultrasound-guided therapy can reduce radiographic progression and improve functional outcomes, and identify predictive factors for sustained remission, absence of structural damage and improvement in functional outcomes. It is hoped that results from the TURA trial will contribute to the development of new and improved disease management principles for RA.

Learn more from Professor Paul Emery at Rheumatology congress EULAR 2012, at the GE Healthcare / Abbott co-sponsored symposium: "Treat to target: What are the benefits of using a targeted ultrasound approach?". Learn more here.

References

1. S molen JS, et al. Ann Rheum Dis 2010;69:631–7.

2. Molenaar ET, et al. Arthritis Rheum 2004;50:36–42.

3. Saleem B, et al. Ann Rheum Dis 2012; 31 Jan [Epub].

4. Brown AK, et al. Arthritis Rheum 2008;58:2958–67.

Treat to target: What are the benefits of using a targeted ultrasound approach?

At EULAR 2012, the Annual European Congress of Rheumatology in Berlin join us at the GE Healthcare / Abbott co-sponsored TUI Satellite Symposium: "Treat to target: What are the benefits of using a targeted ultrasound approach?"

According to the symposium chairman Paul Emery, Arthritis Research UK Professor of Rheumatology, "Treat to Target (T2T) has revolutionised the management of rheumatoid arthritis (RA), making clinical remission a realistic goal for many patients. Imaging modalities are critical for the early diagnosis and monitoring of RA. Application of tools such as sonography in conjunction with T2T principles may further improve clinical outcomes"

Few words about TUI initiative:

Targeted Ultrasound Initiative (TUI) is an international effort led by a world-leading faculty of rheumatologists and ultrasound leads (18 experts from UK, France, Italy, Spain, Germany, Denmark, Japan, Hungary) to help increase the expertise of ultrasonography amongst a network of rheumatologists. TUI also aims to create a network of researchers to undertake multinational research to answer critical questions in the application of ultrasound to clinical practice. http://www.targetedultrasound.net/

Learn more about symposium at EULAR 2012.

Rheumatology...Advancing bone and joint health, helping improve quality of life.

More than 100 million people in Europe are affected by arthritis and/or rheumatism, making it Europe's most widespread chronic disease.¹

Every 30 seconds, a fracture occurs due to osteoporosis.²  Can this be prevented?

A new era of imaging has led to better understanding of bone and joint health. Studies show that early diagnosis and clinical management can help enhance care and contain costs.^3,4

Help enhance care standards and improve quality of life for your patients...

1.PARE Manifesto Steering Group; The PARE Manifesto: A call to Action.

2. Blanchard F, President,Report Working Group. Report on Osteoporosis in the European Community: Building Strong Bones and Preventing Fractures - Action to Prevention. European Communities, Brussels, 1998, EC Report CE-09-97-915-EN-C

3. Fit For Work? (2009) Musculoskeletal Disorders in the European Workforce, Stephen Bevan, Tatiana Quadrello, Robin McGee, Michelle Mahdon, Anna Vavrovsky, Leela Barha

4. V.P.K. Nell, K.P. Machold, G. Eberl, T.A. Stamm, M.Uffmann and J.S. Smolen, Benefit of very early referral and very early therapy with disease-modifying anti-rheumatic drugs in Rheumatology, 2004:43:906_914

What is the new gold standard for Aortic Aneurysm Repair?

In a recent interview with Professor Stéphan Haulon*, Vascular Surgery Department, University Hospital of Lille, France, he addresses the adoption of minimally invasive endovascular aortic repair (EVAR) aided by advanced clinical imaging device solutions from GE Healthcare.

One of the key questions, “ Is open surgery for the repair of aortic aneurysms the ‘gold standard’ or is it the ‘old standard?’”

A majority of surgeons agreed open surgery is rapidly becoming the "old standard" in a debate on this question at the 2010 Joint Meeting of the Society of Vascular Surgery and the European Society for Vascular Surgery.
                                            
In an exclusive e-book “Advanced Endovascular Surgery”, Prof Haulon describes his experience using a mobile hybrid OR.

A new class of vascular surgeons is emerging in aortic repair - Thanks to major advances in the treatment of large-vessel
 aneurysms, the movement to treat vascular abnormalities using minimally invasive techniques is accelerating.
Abdominal aortic aneurysms (AAA) represent a genuine unmet medical need, affecting an estimated 5% of adults over
the age of 65 years diagnosed with this life-threatening condition. Sudden death is nearly certain for patients in the event
of a rupture, where as the risk of mortality is reduced to less than 5% in the surgical repair of the aneurysm.

 Want to know more? View the postcard videos from the 2010 Charing Cross symposium
- Advantages of mobile hybrid operating room
- Radiation study on mobile C-arms and aortic endografting

 

 

For an overview of our innovative surgery products visit our Radiology News site.

*Prof. Haulon provides consultation to GE Healthcare