Spondyloarthritis & psoriatic arthritis
Measuring the Impact: Magnetic Resonance Imaging Response of Sacroiliac Joints to Tumor Necrosis Factor Inhibitors in Youth With Axial Disease
Authors' conclusion
Most participants showed early imaging response to TNFi, with most improvement occurring within 12 weeks.
Study context
- Population
- Youth aged 8 to 18 years with a clinical diagnosis of axial juvenile spondyloarthritis (axJSpA) starting tumor necrosis factor inhibitor (TNFi)62 with magnetic resonance imaging (MRI)-confirmed axJSpA
- Participants
- 75 participants
- Outcome
- Resolution of sacroiliac joint (SIJ) inflammation on MRI (SPARCC SIJ inflammation score, SIS)
- Follow-up
- 12 weeks
Methodological detailsmulticentre, blinded MRI reading (three reviewers)
- Multicentre
- Blinded MRI reading (three reviewers)
Main finding
As reported in the abstract
SIJ inflammation scores (SIS) improvement, 51 of 57
89%
Inflammation resolution (SIS <2), 36 of 57
63%
Median SIS change from baseline (IQR −18 to −3)
−8
Observational data: associations, not effects.
Further findings
At least moderate clinical improvement in those with persistent inflammation at 12 weeks (n = 26)
- Reported at least moderate clinical improvement
- 85%
Ongoing inflammation at 24 weeks
- Ongoing inflammation, 14 of 25
- 56%
Share of SIS improvement occurring within first 12 weeks
- SIS improvement within the first 12 weeks
- 84%
Structural lesion scores, baseline to 12-week scan (decreased/increased/same), patients with at least two scans
- Erosions
- 58%/25%/18%
- Sclerosis
- 21%/9%/70%
- Fat metaplasia
- 0%/30%/70%
- Backfill
- 4%/28%/68%
Original publication
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