POWER Doppler ultrasound may provide important signals in predicting treatment response for patients with rheumatoid arthritis (RA), though its ability to forecast remission remains uncertain, according to a new systematic review.
The review assessed whether baseline power Doppler activity in musculoskeletal ultrasound could guide therapeutic decisions for patients with RA with moderate to high disease activity. Investigators screened 2,580 records and included 13 studies that evaluated the predictive value of Doppler findings on treatment outcomes.
Findings varied across studies, reflecting differences in inclusion criteria, treatment regimens, scanned joints, and follow-up duration. In eight studies, patients with higher baseline Doppler activity demonstrated better improvement after treatment escalation, showing greater reductions in clinical disease activity scores. However, two studies suggested that higher Doppler scores at baseline actually reduced the likelihood of achieving remission. The remaining three studies found no significant association between Doppler signals and remission at follow-up.
The authors noted that while Doppler severity at baseline may indicate greater symptomatic improvement, it does not consistently predict achievement of remission. This uncertainty underscores the need for more standardized research that identifies outcome measures relevant to both clinical practice and patient management.
Overall, the findings suggest that power Doppler has potential value in refining treatment decisions for RA, but further well-designed studies are essential before it can be incorporated into routine prediction models.
Reference:
Gazel U et al. The prediction of response to treatment using power Doppler in rheumatoid arthritis: a systematic review. Rheumatol Adv Pract. 2025;9(3):rkaf082.
