Torgutalp Murat, Rademacher Judith, Proft Fabian, Hermann Kay-Geert, Althoff Christian, Haibel H, Protopopov Mikhail, Sieper Joachim, Rios Rodriguez Valeria, Poddubnyy Denis
Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine), Charite Universitatsmedizin Berlin, Berlin, Germany.
Berlin Institute of Health at Charite, Berlin, Germany.
RMD Open. 2025 Jan 6;11(1):e004921. doi: 10.1136/rmdopen-2024-004921.
In this post-hoc analysis of ESTHER trial, we aimed to investigate the longitudinal relationship between inflammation on MRI and the achievement of inactive disease/low disease activity in patients with axial spondyloarthritis (axSpA) treated with long-term tumor necrosis factor (TNF) inhibitor etanercept.
Of the 76 patients with active axSpA in the ESTHER trial, we included all patients treated with etanercept for at least 6 months for main analysis. All clinical and MRI data from 4.5 years of follow-up were used in the analysis. MRIs of the spine and sacroiliac (SI) joints were performed at baseline, week 24, week 48 and yearly thereafter and were evaluated for active inflammatory lesions according to the Berlin MRI score.
Longitudinal analysis showed that higher SI joint osteitis score was associated with higher Axial Spondyloarthritis Disease Activity Score (ASDAS) at the same time point (β=0.08, 95% CI (0.05; 0.11)) and at the next time point 6 months later (β=0.05, 95% CI (0.02; 0.07)). Furthermore, resolution of osteitis in the SI joint (Berlin MRI osteitis score of ≤1) was associated with lower ASDAS at the next time point (β=-0.26, 95% CI (-0.42; -0.09)), higher odds of achieving ASDAS low disease activity (OR=5.61, 95% CI (1.06; 29.67)) and inactive disease status (OR=2.23, 95% CI (1.01; 4.94)) at the next time point.
The presence of inflammation on SI joints-MRI is associated with higher disease activity in axSpA. Resolution of inflammation on MRI is associated with better clinical outcomes in the long-term follow-up. Thus, achieving complete resolution of inflammation is favourable for meeting the treatment goals in axSpA.
NCT00844142.
在这项针对依那西普治疗脊柱关节炎（ESTHER）试验的事后分析中，我们旨在研究长期使用肿瘤坏死因子（TNF）抑制剂依那西普治疗的中轴型脊柱关节炎（axSpA）患者中，MRI上的炎症与疾病缓解/低疾病活动度达成之间的纵向关系。
在ESTHER试验的76例活动性axSpA患者中，我们纳入了所有接受依那西普治疗至少6个月的患者进行主要分析。分析使用了4.5年随访期内的所有临床和MRI数据。在基线、第24周、第48周以及此后每年进行脊柱和骶髂（SI）关节的MRI检查，并根据柏林MRI评分评估活动性炎性病变。
纵向分析显示，在同一时间点（β=0.08，95%置信区间（0.05；0.11））以及6个月后的下一个时间点（β=0.05，95%置信区间（0.02；0.07）），较高的SI关节骨炎评分与较高的中轴型脊柱关节炎疾病活动度评分（ASDAS）相关。此外，SI关节骨炎的消退（柏林MRI骨炎评分为≤1）与下一个时间点较低的ASDAS相关（β=-0.26，95%置信区间（-0.
