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Sacroiliac Joint Ankylosis In Young Spondyloarthritis Patients Receiving Biologic Therapy: Observation of Serial MRI scans

Bray, TJP; Lopes, A; Fisher, C; Ciurtin, C; Sen, D; Hall-Craggs, MA; (2019) Sacroiliac Joint Ankylosis In Young Spondyloarthritis Patients Receiving Biologic Therapy: Observation of Serial MRI scans. Arthritis and Rheumatology , 71 (4) pp. 594-598. 10.1002/art.40750. Green open access

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Abstract

Objectives: To assess the temporal relationship between initiating biologic therapy and magnetic resonance imaging (MRI) scores of inflammation and structural damage in young patients with spondyloarthritis. / Methods: A local adolescent rheumatology database was searched for patients aged 12 – 24 years with sacroiliitis on MRI and a clinical diagnosis of enthesitis‐related arthritis (ERA) or non‐radiographic axial spondyloarthritis. Patients treated with tumour necrosis factor inhibitor (TNFi) therapy with a minimum of one scan before and two after starting TNFi therapy (over ≥ 2 years) were included. Images of the sacroiliac joints were scored for inflammation and structural abnormalities (including erosions, fat metaplasia and fusion). The effects of TNFi therapy and of time since initiation of TNFi therapy on inflammation and structural abnormalities were assessed using a mixed‐effects regression analysis. / Results: Twenty‐nine patients aged 12‐23 years undergoing TNFi therapy were included. Inflammation scores were significantly lower in patients on treatment (P=0.013), but there was no significant effect of time from TNFi initiation on inflammation (P=0.125). Conversely, there was no significant effect of treatment itself on fusion scores (P=0.285), but fusion scores significantly increased with time from TNFi initiation (P=0.000). A similar pattern was observed for fat metaplasia. Fusion scores did not change in the first year after starting TNFi therapy (P=0.108), but were significantly increased at all subsequent time points (P=0.000 to 0.001). / Conclusions: TNFi therapy failed to prevent the eventual development of joint ankylosis in this cohort, despite a substantial reduction in inflammation with TNFi therapy.

Type: Article
Title: Sacroiliac Joint Ankylosis In Young Spondyloarthritis Patients Receiving Biologic Therapy: Observation of Serial MRI scans
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/art.40750
Publisher version: https://doi.org/10.1002/art.40750
Language: English
Additional information: Copyright © 2018 The Authors. Arthritis & Rheumatology published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Keywords: Spondyloarthritis, ankylosing spondylitis, magnetic resonance imaging, juvenile idiopathic arthritis
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > CRUK Cancer Trials Centre
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Department of Imaging
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation
URI: https://discovery.ucl.ac.uk/id/eprint/10058204
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