Imaging Scoring Methods in Axial Spondyloarthritis

Baraliakos, Xenofon; Braun, J.

doi:10.1016/j.rdc.2016.07.006

Cited by 18 publications

(8 citation statements)

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“…20 and analysed centrally using the Berlin modification of the ASspiMRI scoring system (Berlin MRI score). 20 MRI imaging of the spine and SIJ was implemented using a standardised scanning procedure monitored by a central imaging service agency to minimise differences among MRI scanners at different imaging centres. Spine images were acquired in two or three overlapping segments to achieve complete sagittal coverage of the spine (from C1 to S1).…”

Section: Outcome Measuresmentioning

confidence: 99%

Secukinumab in patients with psoriatic arthritis and axial manifestations: results from the double-blind, randomised, phase 3 MAXIMISE trial

et al. 2020

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ObjectivesMAXIMISE (Managing AXIal Manifestations in psorIatic arthritis with SEcukinumab) trial was designed to evaluate the efficacy of secukinumab in the management of axial manifestations of psoriatic arthritis (PsA).MethodsThis phase 3b, double-blind, placebo-controlled, multi-centre 52-week trial included patients (≥18 years) diagnosed with PsA and classified by ClASsification criteria for Psoriatic Arthritis (CASPAR) criteria, with spinal pain Visual Analogue Score ≥40/100 and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score ≥4 despite use of at least two non-steroidal anti-inflammatory drugs (NSAIDs). Patients were randomised (1:1:1) to secukinumab 300 mg, secukinumab 150 mg or placebo weekly for 4 weeks and every 4 weeks thereafter. At week 12, placebo patients were re-randomised to secukinumab 300/150 mg. Primary endpoint was ASAS20 (Assessment of SpondyloArthritis international Society) response with secukinumab 300 mg at week 12.ResultsPatients were randomly assigned; 167 to secukinumab 300 mg, 165 to secukinumab 150 mg and 166 to placebo. Secukinumab 300 mg and 150 mg significantly improved ASAS20 response versus placebo at week 12 (63% and 66% vs 31% placebo). The OR (95% CI) comparing secukinumab 300 mg and 150 mg versus placebo, using a logistic regression model after multiple imputation, was 3.8 (2.4 and 6.1) and 4.4 (2.7 and 7.0; p<0.0001).ConclusionsSecukinumab 300 mg and 150 mg provided significant improvement in signs and symptoms of axial disease compared with placebo in patients with PsA and axial manifestations with inadequate response to NSAIDs.Trial registration numberNCT02721966.

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Section: Outcome Measuresmentioning

confidence: 99%

Secukinumab in patients with psoriatic arthritis and axial manifestations: results from the double-blind, randomised, phase 3 MAXIMISE trial

et al. 2020

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“…Inflammatory changes are objective signs of axSpA. Inflammation in the SIJ (sacroiliitis) and in spine (spondylitis) can be visualized as BME [20]. If the inflammation is not controlled, structural changes such as fat metaplasia, erosions, sclerosis, or ankylosis in SIJ and vertebral edge would appear in successive years, which is so called radiographic progression.…”

Section: Discussionmentioning

confidence: 99%

“…inflammation site, but also displays the bone erosion and osteosclerosis of joint surface, can sensitively find the edema of the bone marrow and the surrounding soft tissue of SIJ and spine [20,47], and is capable of making a diagnosis of inflammation before the obvious morphological change in X-ray and CT [48]. Moreover, previous studies indicated that lesions identified by MRI had a predictive capacity for the development of sacroiliitis [49,50].…”

Section: Plos Onementioning

confidence: 99%

“…To detect and supervise inflammation or structure damage of the joints, among the several available radiology methods, such as X-ray, computed tomography (CT), magnetic resonance imaging (MRI), MRI is considered as the best imaging technique [20], which shows a high sensitivity on detecting the inflammation lesion generally manifested as bone marrow edema (BME) at SIJ and spine [21,22]. In recent years, MRI has become an important evaluation method for axSpA, especially in patients with inconclusive findings or negative findings on X-rays.…”

Section: Introductionmentioning

confidence: 99%

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Impact of tumor necrosis factor α inhibitors on MRI inflammation in axial spondyloarthritis assessed by Spondyloarthritis Research Consortium Canada score: A meta-analysis

et al. 2020

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Spondyloarthritis Research Consortium Canada (SPARCC) score is an effective magnetic resonance imaging (MRI) evaluation method for inflammation in axial spondyloarthritis. Previously published meta-analyses have shown tumor necrosis factor α inhibitors (TNFi) had great effectiveness on improving disease activity and function in axial spondyloarthritis. However, there still has no one that concentrates on the impact of TNFi on MRI inflammation. We conduct a meta-analysis to summarize the impact of TNFi on MRI inflammation in axial spondyloarthritis using SPARCC score. Comprehensive search was conducted in the databases of OVID Medline, OVID EMBASE, and Cochrane library on November 14, 2020. We investigated the differences in SPARCC score of sacroiliac joint and spine, before and after TNFi treatment in patients with axial spondyloarthritis. SPARCC score was further compared in the subgroup by diagnostic category and TNFi types. In addition, clinical assessment indicators including ankylosing spondylitis disease activity score, bath ankylosing spondylitis disease activity index, bath ankylosing spondylitis functional index, c-reactive protein were also analyzed. Data were pooled by mean differences (MD) with 95% confidence intervals (CI) and publication bias was assessed by Egger’s test. Jadad scale was applied to assess the quality of included trials. Compared with control group, TNFi significantly improved SPARCC score of sacroiliac joints (n = 11, MD = 2.86, 95% CI 2.50, 3.23) and spine (n = 5, MD = 1.87,95%CI 1.27, 2.46). This effect was consistent among subgroups by different diagnostic category (ankylosing spondylitis, non-radiographic axial spondyloarthritis) and TNFi types (adalimumab, certolizumab pegol). Analysis of clinical assessment indicators also confirmed the therapeutic effect on axial spondyloarthritis. Egger’s test suggested no possibility of publication bias. This meta-analysis shows that TNFi are effective to improve MRI inflammation in patients with axial spondyloarthritis and the treatment effectiveness is not affected by diagnostic category and TNFi types.

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“…In addition to a the binary approach of lesions being present or absent, quantification of the extension of BME lesions was performed based on the definitions of the Berlin SIJ and spine MRI Score. 20 Briefly, this score captures BME in a scale of 0-3. Both for the SIJ and the spine, a score of 0 means no BME, while a score of 1, 2 and 3 mean 0% to ≤33%, >33% to ≤66% and >66% of an SIJ quadrant or and 0% to ≤25%, >25% to ≤50% and >50% of a discovertebral unit, respectively.…”

Section: Mri and Reading Of Imagesmentioning

confidence: 99%

Which factors are associated with bone marrow oedema suspicious of axial spondyloarthritis as detected by MRI in the sacroiliac joints and the spine in the general population?

et al. 2020

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ObjectiveIdentify factors associated with presence and extension of spinal and sacroiliac joints (SIJ)–MRI lesions suggestive of axial spondyloarthritis (axSpA) in a population-based cohort (Study of Health in Pomerania) aged <45 years.MethodsSpinal (sagittal T1/T2) and SIJ (semicoronal STIR sequences) MRIs were evaluated by two trained blinded readers. The presence (yes/no) and extension (Berlin MRI Score) of bone marrow oedema (BME) were captured. Degenerative spinal lesions were excluded and discrepancies resolved by consensus. Cross-sectional associations between clinical factors and presence/extension of BME were analysed by logistic/negative binomial regression. Record linkage of claims data was applied to identify participants with axSpA.ResultsMRIs of 793 volunteers were evaluated. The presence of SIJ–BME (odds ratio) was strongly associated delivery during the last year (4.47, 1.49–13.41). For SIJ–BME extension, associations (incidence rate ratios, 95% CI) were found for delivery ((during last year) 4.52, 1.48–13.84), human leucocyte antigen (HLA)-B27+ (2.32, 1.30–4.14), body mass index (25–30 vs <25 kg/m²; 1.86 (1.19–2.89)) and back pain ((last 3 months) 1.55, 1.04–2.31), while for spinal BME, associations were found for age per decade (1.46, 1.13–1.90) and physically demanding work (1.46, 1.06–2.00). Record linkage was available for 694 (87.5%) participants and 9/694 (1.3%) had a record of axSpA (ICD M45.09).ConclusionThese population-based data support the hypothesis of mechanic strain contributing to BME in the general population aged <45 years and the role of HLA-B27+ as a severity rather than a susceptibility factor for SIJ–BME.

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Imaging Scoring Methods in Axial Spondyloarthritis

Cited by 18 publications

References 38 publications

Secukinumab in patients with psoriatic arthritis and axial manifestations: results from the double-blind, randomised, phase 3 MAXIMISE trial

Secukinumab in patients with psoriatic arthritis and axial manifestations: results from the double-blind, randomised, phase 3 MAXIMISE trial

Impact of tumor necrosis factor α inhibitors on MRI inflammation in axial spondyloarthritis assessed by Spondyloarthritis Research Consortium Canada score: A meta-analysis

Which factors are associated with bone marrow oedema suspicious of axial spondyloarthritis as detected by MRI in the sacroiliac joints and the spine in the general population?

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