Continuous efficacy of etanercept in severe and advanced ankylosing spondylitis: results from a 12-week open-label extension of the SPINE study

Dougados, Maxime; Braun, Jürgen; Szántó, Sándor; Combe, Bernard; Géher, Pál; Leblanc, Véronique; Logeart, I.

doi:10.1093/rheumatology/kes125

Cited by 24 publications

(6 citation statements)

References 19 publications

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“…Whether TNF blockers could affect the radiographic progression in patients with axSpA remains a perennial discussion. The “TNF-brake hypothesis” has been a popular theory attempting to explain the dissociation between the improvement of disease activity and new bone formation ( 32 , 33 ). Inflammation resolution achieved by TNF blockers could potentially give rise to the development of fatty lesions, which had been proved be to significantly associated with syndesmophytes.…”

Section: Discussionmentioning

confidence: 99%

Quantification of Fat Metaplasia in the Sacroiliac Joints of Patients With Axial Spondyloarthritis by Chemical Shift-Encoded MRI: A Diagnostic Trial

et al. 2022

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ObjectiveTo study the diagnostic performance of chemical shift-encoded MRI (CSE-MRI) in the diagnosis of axial spondyloarthritis (axSpA).MethodsCSE-MRI images were acquired for consecutive patients complaining of back pain as well as healthy volunteers. Proton density fat fraction (PDFF) values were measured independently by two readers. Diagnostic performance of CSE-MRI was analyzed by sensitivity analysis and ROC curve analysis. Logistic regression analysis was employed to investigate the risk factors of extensive fat deposition in the SIJs.ResultsA total of 52 r-axSpA patients, 37 nr-axSpA patients, 24 non-SpA patients and 34 healthy volunteers were included. Mean PDFF values in the SIJs of patients with r-axSpA and nr-axSpA (72.7% and 64.5%) were significantly higher than non-SpA patients and healthy volunteers (56.0% and 57.6%) (p<0.001). By defining extensive fat deposition in the SIJs as ≥8 ROIs with PDFF values over 70%, its sensitivity and specificity in diagnosing axSpA reached 72.47% and 86.21%%. By joining bone marrow edema (BME) with ≥8 ROIs (PDFF>70%), 22 (24.71%) and 23 (25.84%) more axSpA patients were classified as SIJ MRI (+) by reader 1 and 2, but specificities decreased by 15.52% and 10.34%. Multivariate logistic regression analysis confirmed longer disease duration as the independent risk factor of extensive fat deposition in SIJs (OR=1.15, 95%CI[1.03, 1.32]), while bDMARDs medication was a protective factor (OR=0.15, 95%CI[0.04, 0.51]).ConclusionCSE-MRI is a reliable tool to quantitively assess the fat metaplasia in the SIJs of axSpA patients. Extensive fat deposition in the SIJs could add incremental diagnostic value to BME, but at the cost of decreased specificities.

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Section: Discussionmentioning

confidence: 99%

Quantification of Fat Metaplasia in the Sacroiliac Joints of Patients With Axial Spondyloarthritis by Chemical Shift-Encoded MRI: A Diagnostic Trial

et al. 2022

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“…Whether bDMARDs and NSAIDs have a synergistic effect on clinical outcomes and slowing of radiographic progression in axSpA remains unclear. There are no studies directly addressing this question, with no major differences noted between continuing or reducing NSAIDs in patients on biologics (for example, the similar outcomes in the SPARSE and SPINE etanercept studies [ 93 , 94 ]).…”

Section: Biologic Dmards In Axspamentioning

confidence: 99%

Treatment strategies in axial spondyloarthritis: what, when and how?

Fragoulis

Siebert

2020

Rheumatology

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There have been major advances in the management of axial spondyloarthritis (axSpA) with the introduction of effective biologic agents targeting TNF and IL-17A. Clinicians now have more choice but, despite treatment recommendations, are still faced with significant uncertainty when deciding on the optimal treatment strategy for an individual patient in clinical practice. Management of axSpA typically requires both non-pharmacological and pharmacological interventions. NSAIDs remain the first line drug therapies for axSpA with proven efficacy for symptomatic management but uncertainty remains regarding their optimal long-term use relating to radiographic progression and safety in axSpA. To-date there are no head-to-head trials of biologics in axSpA. Clinicians need to consider other factors, including extra-articular manifestations, comorbidities, safety and radiographic progression when deciding on which biologic to recommend for an individual patient. This article will explore the evidence relating to these factors and highlight areas of unmet need.

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“…However, 15% to 32% of patients show inadequate response (lack of efficacy or safety issues) within the 2 years after starting the first TNFi. We lack recommendations on the choice of a second-line TNFi (2,3,6,7). Moreover, across published studies, predictors of a switch to a second TNFi are controversial.…”

Section: Introductionmentioning

confidence: 99%

Drug maintenance of a second tumor necrosis factor alpha inhibitor in spondyloarthritis patients: A real-life multicenter study

Krajewski

Andras²,

Pereira-Gillion

et al. 2019

Joint Bone Spine

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Continuous efficacy of etanercept in severe and advanced ankylosing spondylitis: results from a 12-week open-label extension of the SPINE study

Cited by 24 publications

References 19 publications

Quantification of Fat Metaplasia in the Sacroiliac Joints of Patients With Axial Spondyloarthritis by Chemical Shift-Encoded MRI: A Diagnostic Trial

Quantification of Fat Metaplasia in the Sacroiliac Joints of Patients With Axial Spondyloarthritis by Chemical Shift-Encoded MRI: A Diagnostic Trial

Treatment strategies in axial spondyloarthritis: what, when and how?

Drug maintenance of a second tumor necrosis factor alpha inhibitor in spondyloarthritis patients: A real-life multicenter study

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