Wojciechowski Rafał
Clinic of Rheumatology and Connective Tissue Diseases, Jan Biziel University Hospital No. 2 in Bydgoszcz, Poland.
Reumatologia. 2025 May 30;63(3):152-158. doi: 10.5114/reum/200528. eCollection 2025.
Axial spondyloarthritis (axSpA) comprises a group of chronic inflammatory joint diseases. Modern therapies enable the rapid achievement of low disease activity or even remission. Therefore, assessing disease activity is now crucial for making the best possible therapeutic decisions. In addition to standard clinical indices used to evaluate disease activity, magnetic resonance imaging (MRI) is increasingly employed to assess inflammation.
The study included patients with axSpA who had a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score ≥ 4 and a Spondyloarthritis Research Consortium of Canada (SPARCC) score ≥ 2. The MRI examinations of the sacroiliac joints were performed at the beginning and the end of the study to evaluate disease activity. The study lasted 3 months, during which patients were treated with certolizumab pegol.
The study included 31 patients with axSpA (11 females, 20 males). The mean age of the patients was 36.7 years (SD 9.7), and the mean disease duration from the onset of the first symptoms was 7.4 years (SD 1.9). At the start of therapy, all patients had active disease, as determined by clinical assessment (BASDAI ≥ 4 and Ankylosing Spondylitis Disease Activity Score [ASDAS] > 2.1) and MRI evaluation (SPARCC ≥ 2). The percentage of patients with active disease after 3 months of therapy was 26% (BASDAI), 19% (ASDAS), and 97% (SPARCC). Significant clinical improvement as a result of the therapy was observed in 81% (ΔBASDAI ≥ 50%), 97% (ΔASDAS ≥ 1.1), and 87% (ΔSPARCC ≥ 2.5) of patients.
Magnetic resonance imaging provides a perspective on disease activity that complements traditionally used clinical indices. It does not replace these indices but rather offers additional insights during both the diagnostic process and the monitoring of therapy efficacy.
轴性脊柱关节炎（axSpA）是一组慢性炎症性关节疾病。现代疗法能够迅速实现低疾病活动度甚至缓解。因此，评估疾病活动度对于做出最佳治疗决策至关重要。除了用于评估疾病活动度的标准临床指标外，磁共振成像（MRI）越来越多地用于评估炎症。
该研究纳入了巴斯强直性脊柱炎疾病活动指数（BASDAI）评分≥4且加拿大脊柱关节炎研究联盟（SPARCC）评分≥2的axSpA患者。在研究开始和结束时对骶髂关节进行MRI检查以评估疾病活动度。研究持续3个月，在此期间患者接受赛妥珠单抗聚乙二醇治疗。
该研究纳入了31例axSpA患者（11例女性患者，20例男性患者）。患者的平均年龄为36.7岁（标准差9.7），从首次出现症状开始计算的平均病程为7.4年（标准差1.9）。在治疗开始时，根据临床评估（BASDAI≥4且强直性脊柱炎疾病活动评分[ASDAS]>2.1）和MRI评估（SPARCC≥2）确定所有患者均患有活动性疾病。治疗3个月后，活动性疾病患者的比例分别为26%（BASDAI）、19%（ASDAS）和97%（SPARCC）。81%（ΔBASDAI≥50%）、97%（ΔASDAS≥1.1）和87%（ΔSPARCC≥2.5）的患者因治疗而出现了显著的临床改善。
磁共振成像提供了关于疾病活动度的视角，补充了传统使用的临床指标。它并非取代这些指标，而是在诊断过程和治疗疗效监测期间提供额外的见解。
