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. 2022 Jan 21;24(1):30.
doi: 10.1186/s13075-021-02695-5.

Sustained low disease activity measured by ASDAS slow radiographic spinal progression in axial spondyloarthritis patients treated with TNF-inhibitors: data from REGISPONSERBIO

Maria Llop  1 , Mireia Moreno  1 , Victoria Navarro-Compán  2 , Xavier Juanola  3 , Eugenio de Miguel  2 , Raquel Almodóvar  4 , Eduardo Cuende Quintana  5 , Jesús Sanz Sanz  6 , Emma Beltrán  7 , M Dolores Ruiz Montesinos  8 , Joan Calvet  1 , Antoni Berenguer-Llergo  9 , Jordi Gratacós  10 ; Regisponserbio group
Collaborators, Affiliations

Sustained low disease activity measured by ASDAS slow radiographic spinal progression in axial spondyloarthritis patients treated with TNF-inhibitors: data from REGISPONSERBIO

Maria Llop et al. Arthritis Res Ther. .

Abstract

Background: To evaluate the influence of the disease activity on radiographic progression in axial spondyloarthritis (axSpA) patients treated with TNF inhibitors (TNFi).

Methods: The study included 101 axSpA patients from the Spanish Register of Biological Therapy in Spondyloarthritides (REGISPONSERBIO), which had clinical data and radiographic assessment available. Patients were classified into 2 groups based on the duration of TNFi treatment at baseline: (i) long-term treatment (≥4 years) and (ii) no long-term treatment (< 4 years). Radiographs were scored by two readers according to the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) with known chronology. Disease activity differences between patients' groups at each time point were assessed using a linear mixed-effect model.

Results: Radiographic progression was defined as an increase in ≥2 mSASSS units. At inclusion, approximately half of the patients (45.5%) were receiving long-term treatment with TNFi (≥4 years). In this group of subjects, a significant difference in averaged Ankylosing Spondylitis disease Activity Score (ASDAS) across follow-up was found between progressors and non-progressors (2.33 vs 1.76, p=0.027, respectively). In patients not under long-term TNFi treatment (54.5%) though, no significant ASDAS differences were observed between progressors and non-progressors until the third year of follow-up. Furthermore, no significant differences were found in progression status, when disease activity was measured by Bath Ankylosing spondylitis Disease Activity Index (BASDAI) and C reactive protein (CRP).

Conclusions: Patients on long-term TNFi treatment with a mean sustained low disease activity measures by ASDAS presented lower radiographic progression than those with active disease.

Keywords: Biological therapies; Inflammation; Outcome measures; Radiology; Spondyloarthritis.

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Conflict of interest statement

All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare no support from any organization for the submitted work, no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years, and no other relationships or activities that could appear to have influenced the submitted work.

Figures

Fig. 1
Fig. 1
Flow chart describing the inclusion of REGISPONSERBIO patients in our study
Fig. 2
Fig. 2
Association between disease activity measured by ASDAS-CRP every 6 months with radiographic progression. Radiographic progression was defined as an increase in the mSASSS score at ≥2 points in patients under TNFi treatment during a follow-up period of 3 years. Bold dots and intervals represent means and ± their corresponding standard errors, as provided by a mixed-effects linear model (no other covariates included)
See this image and copyright information in PMC

References

    1. Poddubnyy D, Sieper J. Mechanism of new bone formation in axial spondyloarthritis. Curr Rheumatol Rep. 2017;19(9):55. doi: 10.1007/s11926-017-0681-5. - DOI - PubMed
    1. van der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum. 1984;27(4):361–368. doi: 10.1002/art.1780270401. - DOI - PubMed
    1. Ramiro S, van der Heijde D, van Tubergen A, Stolwijk C, Dougados M, van den Bosch F, et al. Higher disease activity leads to more structural damage in the spine in ankylosing spondylitis: 12-year longitudinal data from the OASIS cohort. Ann Rheum Dis. 2014;73(8):1455–1461. doi: 10.1136/annrheumdis-2014-205178. - DOI - PubMed
    1. van der Heijde D, Landewé R, Einstein S, Ory P, Vosse D, Ni L, et al. Radiographic progression of ankylosing spondylitis after up to two years of treatment with etanercept. Arthritis Rheum. 2008;58(5):1324–1331. doi: 10.1002/art.23471. - DOI - PubMed
    1. van der Heijde D, Landewé R, Baraliakos X, Houben H, van Tubergen A, Williamson P, et al. Radiographic findings following two years of infliximab therapy in patients with ankylosing spondylitis. Arthritis Rheum. 2008;58(10):3063–3070. doi: 10.1002/art.23901. - DOI - PubMed

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