Non-radiographic Axial Spondyloarthritis Patients Without Initial Evidence of Inflammation May Develop Objective Inflammation over Time

Overview

Journal Rheumatology (Oxford)

Publisher Oxford University Press

Specialty Rheumatology

Date 2017 Apr 8

PMID 28387855

Citations 11

Authors

Xenofon Baraliakos

Joachim Sieper

Su Chen

Aileen L Pangan

Jaclyn K Anderson

Affiliations

Soon will be listed here.

Abstract

Objectives: In patients with active axial spondyloarthritis (axSpA), inflammation in the SIJ or spine on MRI, an elevated CRP level or both are considered useful objective assessments for disease activity and initiation of TNF antagonists. The aim of this post hoc analysis of the randomized, double-blind ABILITY-1 study (NCT00939003) was to assess changes in objective inflammation over time.

Methods: Patients with non-radiographic axSpA (nr-axSpA) were randomized to receive adalimumab 40 mg every other week or placebo for 12 weeks in ABILITY-1. MRIs were performed at baseline and week 12; CRP was measured every 4 weeks.

Results: Of 94 placebo-treated ABILITY-1 patients, 29 (30.9%) had a normal MRI of the SIJs and spine, 57 (60.6%) had normal CRP and 20 (21.3%) had a normal MRI of the SIJs and spine and a normal CRP at baseline. After 12 weeks of placebo, 9/29 (31.0%) patients subsequently developed inflammation on MRI, 14/57 (24.6%) patients developed elevated CRP and 10/20 (50.0%) patients developed a positive MRI and/or elevated CRP through week 12.

Conclusions: Patients who have clinically active disease but who lack objective evidence of inflammation initially may benefit from subsequent retesting for inflammation to guide treatment.

Citing Articles

Australian Consensus Statements for the Assessment and Management of Non-radiographic Axial Spondyloarthritis.

Truong S, McEwan T, Bird P, Lim I, Saad N, Schachna L Rheumatol Ther. 2021; 9(1):1-24.

PMID: 34962620 PMC: 8814294. DOI: 10.1007/s40744-021-00416-7.

Secukinumab in axial spondyloarthritis: a narrative review of clinical evidence.

Braun J, Kiltz U, Buhring B, Baraliakos X Ther Adv Musculoskelet Dis. 2021; 13:1759720X211041854.

PMID: 34471428 PMC: 8404628. DOI: 10.1177/1759720X211041854.

The Effect of Etanercept in Nonradiographic Axial Spondyloarthritis by Stratified C-Reactive Protein Levels.

Tam H, Nash P, Robinson P ACR Open Rheumatol. 2021; 3(10):699-706.

PMID: 34405589 PMC: 8516106. DOI: 10.1002/acr2.11312.

Clinical Manifestations and Diagnosis of Axial Spondyloarthritis.

Walsh J, Magrey M J Clin Rheumatol. 2020; 27(8):e547-e560.

PMID: 33105312 PMC: 8612900. DOI: 10.1097/RHU.0000000000001575.

Non-radiographic versus radiographic axSpA: what's in a name?.

Michelena X, Lopez-Medina C, Marzo-Ortega H Rheumatology (Oxford). 2020; 59(Suppl4):iv18-iv24.

PMID: 33053190 PMC: 7566325. DOI: 10.1093/rheumatology/keaa422.

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