Changes over time in inflammatory and structural lesions at the sacroiliac joint in children with spondyloarthritis exposed and unexposed to tumor necrosis factor inhibitor

Abstract Background The objective of this work was to describe magnetic resonance imaging (MRI) changes over time in inflammatory and structural lesions at the sacroiliac joint (SIJ) in children with spondyloarthritis (SpA) exposed and unexposed to tumor necrosis factor inhibitor (TNFi). Methods Thi...

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Autores principales:	Timothy G. Brandon, Rui Xiao, Rosemary G. Peterson, Nancy A. Chauvin, Michael L. Francavilla, David M. Biko, Dax G. Rumsey, Matthew L. Stoll, Pamela F. Weiss
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	SACROILIAC JOINT MAGNETIC RESONANCE IMAGING PEDIATRICS SPONDYOLARTHRITIS DISEASE PROGRESSION TUMOR NECROSIS FACTOR INHIBITORS Pediatrics RJ1-570 Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/f96ccf5aed644fedae784d878da66d03
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spelling	oai:doaj.org-article:f96ccf5aed644fedae784d878da66d032021-12-05T12:04:34ZChanges over time in inflammatory and structural lesions at the sacroiliac joint in children with spondyloarthritis exposed and unexposed to tumor necrosis factor inhibitor10.1186/s12969-021-00647-61546-0096https://doaj.org/article/f96ccf5aed644fedae784d878da66d032021-12-01T00:00:00Zhttps://doi.org/10.1186/s12969-021-00647-6https://doaj.org/toc/1546-0096Abstract Background The objective of this work was to describe magnetic resonance imaging (MRI) changes over time in inflammatory and structural lesions at the sacroiliac joint (SIJ) in children with spondyloarthritis (SpA) exposed and unexposed to tumor necrosis factor inhibitor (TNFi). Methods This was a retrospective, multicenter study of SpA patients with suspected or confirmed sacroiliitis who underwent at ≥2 pelvic MRI scans. Images were reviewed independently by 3 radiologists and scored for inflammatory and structural changes using the Spondyloarthritis Research Consortium of Canada (SPARCC) SIJ inflammation score (SIS) and structural score (SSS). Longitudinal, quantitative changes in patient MRI scans were measured using descriptive statistics and stratified by TNFi exposure. We used an average treatment effects (ATE) regression model to explore the average effect of TNFi exposure over time on inflammatory and structural lesions, adjusting for baseline lesion scores. Results Forty-six subjects were evaluated using the SIS (n = 45) and SSS (n = 18). Median age at baseline imaging was 13.6 years, 63% were male and 71% were white. Twenty-three subjects (50%) were TNFi exposed between MRI studies. The median change in SIS in TNFi exposed and unexposed subjects with a baseline SIS ≥0 was − 20.7 and − 14.3, respectively (p = 0.09). Eleven (85%) TNFi exposed and 8 (89%) unexposed subjects with a baseline SIS ≥0 met the SIS minimal clinically important difference (MCID; ≥2.5). Using the ATE model adjusted for baseline SIS, the average effect of TNFi on SIS in patients with a baseline SIS ≥2 was − 14.5 (p < 0.01). Unadjusted erosion change score was significantly worse in TNFi unexposed versus exposed subjects (p = 0.03) but in the ATE model the effect of TNFi was not significant. Conclusion This study quantitatively describes how lesions in the SIJs on MRI change over time in patients exposed to TNFi versus unexposed. Follow-up imaging in TNFi exposed patients showed greater improvement than the unexposed group by most metrics, some of which reached statistical significance. Surprisingly, a majority of TNFi unexposed children with a baseline SIS≥2 met the SIS MCID. Additional studies assessing the short and long-term effects of TNFi on inflammatory and structural changes in juvenile SpA are needed.Timothy G. BrandonRui XiaoRosemary G. PetersonNancy A. ChauvinMichael L. FrancavillaDavid M. BikoDax G. RumseyMatthew L. StollPamela F. WeissBMCarticleSACROILIAC JOINTMAGNETIC RESONANCE IMAGINGPEDIATRICSSPONDYOLARTHRITISDISEASE PROGRESSIONTUMOR NECROSIS FACTOR INHIBITORSPediatricsRJ1-570Diseases of the musculoskeletal systemRC925-935ENPediatric Rheumatology Online Journal, Vol 19, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	SACROILIAC JOINT MAGNETIC RESONANCE IMAGING PEDIATRICS SPONDYOLARTHRITIS DISEASE PROGRESSION TUMOR NECROSIS FACTOR INHIBITORS Pediatrics RJ1-570 Diseases of the musculoskeletal system RC925-935
spellingShingle	SACROILIAC JOINT MAGNETIC RESONANCE IMAGING PEDIATRICS SPONDYOLARTHRITIS DISEASE PROGRESSION TUMOR NECROSIS FACTOR INHIBITORS Pediatrics RJ1-570 Diseases of the musculoskeletal system RC925-935 Timothy G. Brandon Rui Xiao Rosemary G. Peterson Nancy A. Chauvin Michael L. Francavilla David M. Biko Dax G. Rumsey Matthew L. Stoll Pamela F. Weiss Changes over time in inflammatory and structural lesions at the sacroiliac joint in children with spondyloarthritis exposed and unexposed to tumor necrosis factor inhibitor
description	Abstract Background The objective of this work was to describe magnetic resonance imaging (MRI) changes over time in inflammatory and structural lesions at the sacroiliac joint (SIJ) in children with spondyloarthritis (SpA) exposed and unexposed to tumor necrosis factor inhibitor (TNFi). Methods This was a retrospective, multicenter study of SpA patients with suspected or confirmed sacroiliitis who underwent at ≥2 pelvic MRI scans. Images were reviewed independently by 3 radiologists and scored for inflammatory and structural changes using the Spondyloarthritis Research Consortium of Canada (SPARCC) SIJ inflammation score (SIS) and structural score (SSS). Longitudinal, quantitative changes in patient MRI scans were measured using descriptive statistics and stratified by TNFi exposure. We used an average treatment effects (ATE) regression model to explore the average effect of TNFi exposure over time on inflammatory and structural lesions, adjusting for baseline lesion scores. Results Forty-six subjects were evaluated using the SIS (n = 45) and SSS (n = 18). Median age at baseline imaging was 13.6 years, 63% were male and 71% were white. Twenty-three subjects (50%) were TNFi exposed between MRI studies. The median change in SIS in TNFi exposed and unexposed subjects with a baseline SIS ≥0 was − 20.7 and − 14.3, respectively (p = 0.09). Eleven (85%) TNFi exposed and 8 (89%) unexposed subjects with a baseline SIS ≥0 met the SIS minimal clinically important difference (MCID; ≥2.5). Using the ATE model adjusted for baseline SIS, the average effect of TNFi on SIS in patients with a baseline SIS ≥2 was − 14.5 (p < 0.01). Unadjusted erosion change score was significantly worse in TNFi unexposed versus exposed subjects (p = 0.03) but in the ATE model the effect of TNFi was not significant. Conclusion This study quantitatively describes how lesions in the SIJs on MRI change over time in patients exposed to TNFi versus unexposed. Follow-up imaging in TNFi exposed patients showed greater improvement than the unexposed group by most metrics, some of which reached statistical significance. Surprisingly, a majority of TNFi unexposed children with a baseline SIS≥2 met the SIS MCID. Additional studies assessing the short and long-term effects of TNFi on inflammatory and structural changes in juvenile SpA are needed.
format	article
author	Timothy G. Brandon Rui Xiao Rosemary G. Peterson Nancy A. Chauvin Michael L. Francavilla David M. Biko Dax G. Rumsey Matthew L. Stoll Pamela F. Weiss
author_facet	Timothy G. Brandon Rui Xiao Rosemary G. Peterson Nancy A. Chauvin Michael L. Francavilla David M. Biko Dax G. Rumsey Matthew L. Stoll Pamela F. Weiss
author_sort	Timothy G. Brandon
title	Changes over time in inflammatory and structural lesions at the sacroiliac joint in children with spondyloarthritis exposed and unexposed to tumor necrosis factor inhibitor
title_short	Changes over time in inflammatory and structural lesions at the sacroiliac joint in children with spondyloarthritis exposed and unexposed to tumor necrosis factor inhibitor
title_full	Changes over time in inflammatory and structural lesions at the sacroiliac joint in children with spondyloarthritis exposed and unexposed to tumor necrosis factor inhibitor
title_fullStr	Changes over time in inflammatory and structural lesions at the sacroiliac joint in children with spondyloarthritis exposed and unexposed to tumor necrosis factor inhibitor
title_full_unstemmed	Changes over time in inflammatory and structural lesions at the sacroiliac joint in children with spondyloarthritis exposed and unexposed to tumor necrosis factor inhibitor
title_sort	changes over time in inflammatory and structural lesions at the sacroiliac joint in children with spondyloarthritis exposed and unexposed to tumor necrosis factor inhibitor
publisher	BMC
publishDate	2021
url	https://doaj.org/article/f96ccf5aed644fedae784d878da66d03
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Changes over time in inflammatory and structural lesions at the sacroiliac joint in children with spondyloarthritis exposed and unexposed to tumor necrosis factor inhibitor

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