INCREASING IMPACT ON STRUCTURAL DAMAGE WITH INCREASING CUMULATIVE INFLAMMATION AT THE SIJOINT QUADRANT LEVEL IN AXIAL SPONDYLOARTHRITIS - 5-YEAR DATA FROM THE DESIR COHORT.
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| Title: | INCREASING IMPACT ON STRUCTURAL DAMAGE WITH INCREASING CUMULATIVE INFLAMMATION AT THE SIJOINT QUADRANT LEVEL IN AXIAL SPONDYLOARTHRITIS - 5-YEAR DATA FROM THE DESIR COHORT. |
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| Authors: | Manica, Santiago Andres Rodrigues1,2, Sepriano, Alexandre2,3, Ramiro, Sofia2,3,4, Landewé, Robert5, Claudepierre, Pascal6, Moltó, Anna7, M., Dougados7, van Lunteren, Miranda3, van der Heijde, Désirée3 |
| Source: | Acta Reumatológica Portuguesa. 2019 Special Issue, p67-68. 2p. |
| Subjects: | SPONDYLOARTHROPATHIES, INFLAMMATION, COHORT analysis, BODY mass index, TREATMENT effectiveness |
| Abstract: | Background: Axial inflammation is a key feature in axial SpA (axSpA). There is lack of data relative to the persistence of BME in the same anatomical quadrant (Q, 8 in total for both SIJ together), regardless of the overall presence of BME. Objective: This study aims to investigate particular patterns of distribution of SIJ-BME across quadrants over time, their persistence over time, and their impact on clinical and structural outcomes. Methods: Patients from the DESIR cohort (early axSpA according to the rheumatologist) with MRI-SIJ available at baseline, 2 and 5 years were included. Each image was scored by 3 trained central readers blinded to chronological order. BME was considered positive if detected in =1/6 slices in each of the 8 quadrants, according to each individual reader. Four different patterns of BME over time were defined (no BME, sporadic pattern, fluctuating BME and persistent BME) considering all 8 quadrants (Figure). The effect of BME patterns on 5-year structural (mNY, mSASSS, =5 erosions and/or fatty lesions in MRI-SIJ) and clinical outcomes (BASFI, BASMI and ASQoL) was evaluated using multilevel generalised estimating equations (GEE) models (taking the individual reader data into account) and linear regression (using the agreement of = 2 out of 3), as appropriate. All models were adjusted for relevant confounders including treatment (Table). Results: In total, 136 patients were included (age 34 (SD 9) years, 50% male, and 63% HLA-B27 positive). 'No BME' was seen in 63 patients (46%), the 'sporadic pattern' in 34 patients (25%), the 'fluctuating pattern' was seen in 21 patients (15%) and the 'persistent BME pattern' was seen in 18 patients (13%). Compared to the 'no BME' pattern (reference), the 'sporadic' [OR (95% CI): 2.1 (1.0;4.5)], 'fluctuating' [OR: 5.6 (2.2;14.4)] and 'persistent' [OR: 7.5 (2.8;19.6)] patterns were associated with higher likelihood to be mNY positive at 5-years, suggesting a gradient between cumulative inflammation and damage. Similar findings were observed for mNY as a continuous outcome variable and for =5 erosions and/or fatty lesions on spinal MRI as outcomes, but not for mSASSS (Table). There was no association between the BME patterns and the clinical outcomes. Conclusion: Only 13% of the patients showed persistent inflammation in the same Q over a 5-year period and in 15% inflammation was fluctuating across different Qs. More structural damage was found in patients with increasing cumulative levels of local inflammation in the quadrant. Even when BME (temporarily) disappears there is an important effect on structural outcomes, and that effect t is independent of treatment. [ABSTRACT FROM AUTHOR] |
| Copyright of Acta Reumatológica Portuguesa is the property of Sociedade Portuguesa de Reumatologia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
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| Items | – Name: Title Label: Title Group: Ti Data: INCREASING IMPACT ON STRUCTURAL DAMAGE WITH INCREASING CUMULATIVE INFLAMMATION AT THE SIJOINT QUADRANT LEVEL IN AXIAL SPONDYLOARTHRITIS - 5-YEAR DATA FROM THE DESIR COHORT. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Manica%2C+Santiago+Andres+Rodrigues%22">Manica, Santiago Andres Rodrigues</searchLink><relatesTo>1,2</relatesTo><br /><searchLink fieldCode="AR" term="%22Sepriano%2C+Alexandre%22">Sepriano, Alexandre</searchLink><relatesTo>2,3</relatesTo><br /><searchLink fieldCode="AR" term="%22Ramiro%2C+Sofia%22">Ramiro, Sofia</searchLink><relatesTo>2,3,4</relatesTo><br /><searchLink fieldCode="AR" term="%22Landewé%2C+Robert%22">Landewé, Robert</searchLink><relatesTo>5</relatesTo><br /><searchLink fieldCode="AR" term="%22Claudepierre%2C+Pascal%22">Claudepierre, Pascal</searchLink><relatesTo>6</relatesTo><br /><searchLink fieldCode="AR" term="%22Moltó%2C+Anna%22">Moltó, Anna</searchLink><relatesTo>7</relatesTo><br /><searchLink fieldCode="AR" term="%22M%2E%2C+Dougados%22">M., Dougados</searchLink><relatesTo>7</relatesTo><br /><searchLink fieldCode="AR" term="%22van+Lunteren%2C+Miranda%22">van Lunteren, Miranda</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22van+der+Heijde%2C+Désirée%22">van der Heijde, Désirée</searchLink><relatesTo>3</relatesTo> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Acta+Reumatológica+Portuguesa%22">Acta Reumatológica Portuguesa</searchLink>. 2019 Special Issue, p67-68. 2p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22SPONDYLOARTHROPATHIES%22">SPONDYLOARTHROPATHIES</searchLink><br /><searchLink fieldCode="DE" term="%22INFLAMMATION%22">INFLAMMATION</searchLink><br /><searchLink fieldCode="DE" term="%22COHORT+analysis%22">COHORT analysis</searchLink><br /><searchLink fieldCode="DE" term="%22BODY+mass+index%22">BODY mass index</searchLink><br /><searchLink fieldCode="DE" term="%22TREATMENT+effectiveness%22">TREATMENT effectiveness</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Background: Axial inflammation is a key feature in axial SpA (axSpA). There is lack of data relative to the persistence of BME in the same anatomical quadrant (Q, 8 in total for both SIJ together), regardless of the overall presence of BME. Objective: This study aims to investigate particular patterns of distribution of SIJ-BME across quadrants over time, their persistence over time, and their impact on clinical and structural outcomes. Methods: Patients from the DESIR cohort (early axSpA according to the rheumatologist) with MRI-SIJ available at baseline, 2 and 5 years were included. Each image was scored by 3 trained central readers blinded to chronological order. BME was considered positive if detected in =1/6 slices in each of the 8 quadrants, according to each individual reader. Four different patterns of BME over time were defined (no BME, sporadic pattern, fluctuating BME and persistent BME) considering all 8 quadrants (Figure). The effect of BME patterns on 5-year structural (mNY, mSASSS, =5 erosions and/or fatty lesions in MRI-SIJ) and clinical outcomes (BASFI, BASMI and ASQoL) was evaluated using multilevel generalised estimating equations (GEE) models (taking the individual reader data into account) and linear regression (using the agreement of = 2 out of 3), as appropriate. All models were adjusted for relevant confounders including treatment (Table). Results: In total, 136 patients were included (age 34 (SD 9) years, 50% male, and 63% HLA-B27 positive). 'No BME' was seen in 63 patients (46%), the 'sporadic pattern' in 34 patients (25%), the 'fluctuating pattern' was seen in 21 patients (15%) and the 'persistent BME pattern' was seen in 18 patients (13%). Compared to the 'no BME' pattern (reference), the 'sporadic' [OR (95% CI): 2.1 (1.0;4.5)], 'fluctuating' [OR: 5.6 (2.2;14.4)] and 'persistent' [OR: 7.5 (2.8;19.6)] patterns were associated with higher likelihood to be mNY positive at 5-years, suggesting a gradient between cumulative inflammation and damage. Similar findings were observed for mNY as a continuous outcome variable and for =5 erosions and/or fatty lesions on spinal MRI as outcomes, but not for mSASSS (Table). There was no association between the BME patterns and the clinical outcomes. Conclusion: Only 13% of the patients showed persistent inflammation in the same Q over a 5-year period and in 15% inflammation was fluctuating across different Qs. More structural damage was found in patients with increasing cumulative levels of local inflammation in the quadrant. Even when BME (temporarily) disappears there is an important effect on structural outcomes, and that effect t is independent of treatment. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Acta Reumatológica Portuguesa is the property of Sociedade Portuguesa de Reumatologia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 2 StartPage: 67 Subjects: – SubjectFull: SPONDYLOARTHROPATHIES Type: general – SubjectFull: INFLAMMATION Type: general – SubjectFull: COHORT analysis Type: general – SubjectFull: BODY mass index Type: general – SubjectFull: TREATMENT effectiveness Type: general Titles: – TitleFull: INCREASING IMPACT ON STRUCTURAL DAMAGE WITH INCREASING CUMULATIVE INFLAMMATION AT THE SIJOINT QUADRANT LEVEL IN AXIAL SPONDYLOARTHRITIS - 5-YEAR DATA FROM THE DESIR COHORT. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Manica, Santiago Andres Rodrigues – PersonEntity: Name: NameFull: Sepriano, Alexandre – PersonEntity: Name: NameFull: Ramiro, Sofia – PersonEntity: Name: NameFull: Landewé, Robert – PersonEntity: Name: NameFull: Claudepierre, Pascal – PersonEntity: Name: NameFull: Moltó, Anna – PersonEntity: Name: NameFull: M., Dougados – PersonEntity: Name: NameFull: van Lunteren, Miranda – PersonEntity: Name: NameFull: van der Heijde, Désirée IsPartOfRelationships: – BibEntity: Dates: – D: 02 M: 04 Text: 2019 Special Issue Type: published Y: 2019 Identifiers: – Type: issn-print Value: 0303464X Titles: – TitleFull: Acta Reumatológica Portuguesa Type: main |
| ResultId | 1 |
