Association between resolution of MRI-detected inflammation and improved clinical outcomes in axial spondyloarthritis under long-term anti-TNF therapy

Study Overview

This study examines the link between MRI-detected inflammation and clinical outcomes in patients with axial spondyloarthritis (axSpA) receiving long-term treatment with the TNF inhibitor etanercept.

Objectives

We aimed to understand how inflammation seen on MRI relates to achieving low disease activity or inactive disease in axSpA patients over time.

Methods

We analyzed data from 76 patients in the ESTHER trial who were treated with etanercept for at least 6 months. We reviewed clinical and MRI data collected over 4.5 years, focusing on MRI scans of the spine and sacroiliac (SI) joints taken at various intervals.

Results

Our findings showed:

  • Higher inflammation scores in the SI joints were linked to increased disease activity scores.
  • Resolution of inflammation in the SI joints was associated with lower disease activity scores at the next assessment.
  • Patients with resolved inflammation had significantly higher chances of achieving low disease activity and inactive disease status.

Conclusions

Inflammation in the SI joints, as seen on MRI, indicates higher disease activity in axSpA. Reducing this inflammation leads to better clinical outcomes over time. Therefore, achieving complete resolution of inflammation is crucial for successful treatment in axSpA patients.

Clinical Trial Registration

Trial Registration Number: NCT00844142

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