Development of the CT Syndesmophyte Score (CTSS) in patients with ankylosing spondylitis: data from the SIAS cohort

Bruin, F. de; Koning, Anoek de; Berg, Rosaline van den; Baraliakos, Xenofon; Braun, J.; Smolen, Josef S; Gaalen, F. van; Reijnierse, M.; Heijde, Desirée van der

doi:10.1136/annrheumdis-2017-212553

Cited by 57 publications

(88 citation statements)

References 9 publications

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“…Clinical data and MRI of the whole spine were collected at baseline, 1 and 2 years. Lateral CR of the cervical and lumbar spine and ldCT of the whole spine with coronal and sagittal reconstructed images were obtained at baseline and 2 years 7. For the present study patients were included if CR and ldCT were present at baseline and 2 years.…”

Section: Methodsmentioning

confidence: 99%

“…The total score ranges from 0 to 72. For ldCT, the anterior and posterior quadrants of the cervical, thoracic and lumbar spine were scored in coronal and sagittal planes (23 VUs in total), scoring eight quadrants per VU 7. The total score ranges from 0 to 552.…”

Section: Methodsmentioning

confidence: 99%

“…Due to technological advances, it is now possible to perform CT of the spine with the relatively low radiation dose of 4 mSv (low-dose CT (ldCT)) 7. With ldCT it is possible to assess the entire vertebral column, thus including the thoracic spine, which doubles the number of available vertebrae.…”

Section: Introductionmentioning

confidence: 99%

“…Recently, the CT Syndesmophyte Score (CTSS) for the analysis of bone proliferation has been developed for ldCT 7. This method has been shown to have good inter-reader reliability and sensitivity to pick up changes.…”

Section: Introductionmentioning

confidence: 99%

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Low-dose CT detects more progression of bone formation in comparison to conventional radiography in patients with ankylosing spondylitis: results from the SIAS cohort

et al. 2017

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Low-dose CT detects more progression of bone formation in comparison to conventional radiography in patients with ankylosing spondylitis: results from the SIAS cohort

et al. 2017

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“…In recent years, 3‐dimensional imaging modalities, including full‐dose computed tomography (CT) and low‐dose CT of the spine, have been evaluated to improve the measurement of radiographic progression of AS (Table ). The thoracic spine has been omitted from radiographic studies because of the difficulty in seeing vertebral changes on conventional radiographs.…”

Section: Introductionmentioning

confidence: 99%

Nonsteroidal Antiinflammatory Drugs as Potential Disease‐Modifying Medications in Axial Spondyloarthritis

Wang

Bathon

Ward

2020

Arthritis & Rheumatology

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Nonsteroidal antiinflammatory drugs (NSAIDs) are the first‐line pharmacotherapy for patients with axial spondyloarthritis (SpA). In recent years, treatment options have expanded with the availability of biologic agents, including tumor necrosis factor inhibitors and interleukin‐17 inhibitors. However, a treatment strategy that clearly prevents syndesmophyte formation has not been established. Observational studies of patients with ankylosing spondylitis indicated potential disease‐modifying effects of NSAIDs, but two randomized trials came to different conclusions. More broadly, whether any of the currently available medications for axial SpA have an effect on spine radiographic progression, beyond symptom control, remains inconclusive. In this article, we will review clinical studies of the disease modification effects of NSAIDs and biologics in axial SpA; examine genetic, animal, and clinical evidence of the effects of NSAIDs on bone formation; and discuss how future studies may investigate the question of disease modification in axial SpA.

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Effect of Therapy on Radiographic Progression in Axial Spondyloarthritis: A Systematic Review and Meta‐Analysis

Karmacharya

Duarte‐García

Dubreuil

et al. 2020

Arthritis & Rheumatology

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Objective. To investigate the effect of therapies on radiographic progression in patients with axial spondyloarthritis (SpA). Methods. A comprehensive database search for studies assessing radiographic progression in axial SpA (particular treatment versus no treatment of interest) was performed. Study-specific standardized mean differences in treatment outcomes at 2 and ≥4 years were estimated and combined using random-effects models.Results. Twenty-four studies in patients with axial SpA were identified, of which 18 involved tumor necrosis factor inhibitors (TNFi), 8 involved nonsteroidal antiinflammatory drugs (NSAIDs), and 1 involved secukinumab. Spinal radiographic progression, as measured by the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS), was not significantly different between TNFi-treated and biologics-naive patients at 2 years (mSASSS difference −0.73 [95% confidence interval (95% CI) −1.52, 0.12], I 2 = 28%) and ≥4 years (mSASSS difference −2.03 [95% CI −4.63, 0.72], I 2 = 63%). Sensitivity analyses restricted to studies with a low risk of bias showed a significant difference in spinal radiographic progression between TNFi-treated and biologics-naive patients at ≥4 years (mSASSS difference −2.17 [95% CI −4.19, −0.15]). No significant difference in spinal radiographic progression was observed between NSAID-treated and control patients (mSASSS difference −0.30 [95% CI −2.62, 1.31], I 2 = 71%) or between secukinumab-treated and biologics-naive patients (mSASSS difference −0.34 [95% CI −0.85, 0.17]). With regard to treatment differences in patients with nonradiographic axial SpA or in patients with radiographic progression measured using the sacroiliac joint score, an insufficient number of studies were available for analysis.Conclusion. Although no significant protective effect of TNFi treatment on spinal radiographic progression was seen over the course of 2 years or ≥4 years in patients with axial SpA, our analysis restricted to studies with a low risk of bias showed a protective effect of TNFi after ≥4 years. Therefore, long-term TNFi exposure might confer beneficial effects on spinal radiographic progression in axial SpA. No difference in radiographic progression at 2 years was seen in either the NSAID or secukinumab treatment groups compared to their controls. Future studies should explore the effects of biologic treatment on radiographic progression, as well as the effects of long-term biologics exposure, in patients with early axial SpA or those with nonradiographic axial SpA.

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Development of the CT Syndesmophyte Score (CTSS) in patients with ankylosing spondylitis: data from the SIAS cohort

Abstract: Using the CTSS, new bone formation in the spine of patients with AS can be assessed reliably. Most progression was seen in the thoracic spine.

Cited by 57 publications

References 9 publications

Low-dose CT detects more progression of bone formation in comparison to conventional radiography in patients with ankylosing spondylitis: results from the SIAS cohort

Low-dose CT detects more progression of bone formation in comparison to conventional radiography in patients with ankylosing spondylitis: results from the SIAS cohort

Nonsteroidal Antiinflammatory Drugs as Potential Disease‐Modifying Medications in Axial Spondyloarthritis

Effect of Therapy on Radiographic Progression in Axial Spondyloarthritis: A Systematic Review and Meta‐Analysis

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