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Association between resolution of MRI-detected inflammation and improved clinical outcomes in axial spondyloarthritis under long-term anti-TNF therapy
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Association between resolution of MRI-detected inflammation and improved clinical outcomes in axial spondyloarthritis under long-term anti-TNF therapy
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Association between resolution of MRI-detected inflammation and improved clinical outcomes in axial spondyloarthritis under long-term anti-TNF therapy
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Journal Article
Association between resolution of MRI-detected inflammation and improved clinical outcomes in axial spondyloarthritis under long-term anti-TNF therapy
2025
Overview
ObjectivesIn this post-hoc analysis of ESTHER trial, we aimed to investigate the longitudinal relationship between inflammation on MRI and the achievement of inactive disease/low disease activity in patients with axial spondyloarthritis (axSpA) treated with long-term tumor necrosis factor (TNF) inhibitor etanercept.MethodsOf the 76 patients with active axSpA in the ESTHER trial, we included all patients treated with etanercept for at least 6 months for main analysis. All clinical and MRI data from 4.5 years of follow-up were used in the analysis. MRIs of the spine and sacroiliac (SI) joints were performed at baseline, week 24, week 48 and yearly thereafter and were evaluated for active inflammatory lesions according to the Berlin MRI score.ResultsLongitudinal analysis showed that higher SI joint osteitis score was associated with higher Axial Spondyloarthritis Disease Activity Score (ASDAS) at the same time point (β=0.08, 95% CI (0.05; 0.11)) and at the next time point 6 months later (β=0.05, 95% CI (0.02; 0.07)). Furthermore, resolution of osteitis in the SI joint (Berlin MRI osteitis score of ≤1) was associated with lower ASDAS at the next time point (β=−0.26, 95% CI (−0.42; −0.09)), higher odds of achieving ASDAS low disease activity (OR=5.61, 95% CI (1.06; 29.67)) and inactive disease status (OR=2.23, 95% CI (1.01; 4.94)) at the next time point.ConclusionsThe presence of inflammation on SI joints-MRI is associated with higher disease activity in axSpA. Resolution of inflammation on MRI is associated with better clinical outcomes in the long-term follow-up. Thus, achieving complete resolution of inflammation is favourable for meeting the treatment goals in axSpA.Trial registration numberNCT00844142.
Publisher
EULAR,BMJ Publishing Group LTD,BMJ Publishing Group
Subject
/ Antirheumatic Agents - administration & dosage
/ Antirheumatic Agents - therapeutic use
/ Axial Spondyloarthritis - diagnosis
/ Axial Spondyloarthritis - drug therapy
/ Axial Spondyloarthritis - etiology
/ Clinical Trials, Phase II as Topic
/ Etanercept - administration & dosage
/ Etanercept - therapeutic use
/ Female
/ Humans
/ Inflammation - diagnostic imaging
/ Male
/ Osteitis - diagnostic imaging
/ Patients
/ Randomized Controlled Trials as Topic
/ Sacroiliac Joint - diagnostic imaging
/ Sacroiliac Joint - pathology
/ Tumor Necrosis Factor Inhibitors
/ Tumor Necrosis Factor Inhibitors - administration & dosage
/ Tumor Necrosis Factor Inhibitors - therapeutic use
