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A prospective cohort study (ALBERTA FORCAST) was carried out to determine if TNF inhibitors affect spinal radiographic advancement in individuals suffering from axial spondyloarthritis and if this is coupled with their impact on inflammation.
Tumor necrosis factor (TNF) inhibitors decrease spinal
radiographic advancement in individuals suffering from radiographic axial
spondyloarthritis that might be partially uncoupled from their impact on
Ankylosing Spondylitis Disease Activity Score (ASDAS) inflammation.
A prospective cohort study (ALBERTA FORCAST) was carried out
to determine if TNF inhibitors affect spinal radiographic advancement in
individuals suffering from axial spondyloarthritis and if this is coupled with
their impact on inflammation.
The study incorporated 314 subjects having axial spondyloarthritis meeting the modified New York criteria. With the aid of the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS), the spine radiographs carried out every two years up to 10 years were scored by two central readers.
Assessment of the indirect
impact of TNF inhibitors on mSASSS was done using generalized estimating
equations by assessing the interaction between TNF inhibitors and ASDAS at the
beginning of each two‐year interval (t). If vital, the link between ASDAS at t
and mSASSS at end of the interval (t+1) was examined in (1) participants treated
with TNF inhibitors in all visits; (2) some visits, and (3) never treated.
Furthermore, the link between TNF inhibitors at t and mSASSS at t+1 (adjusting
for ASDAS at t) was also evaluated (direct effect).
A
gradient was witnessed for the impact of ASDAS at t on mSASSS at t+1, with an
elevated advancement in individuals never treated with TNF inhibitors in
comparison with individuals continuously treated (indirect effect). The TNF
inhibitors were also found to directly slow advancement as treated individuals
had on average 0.85 mSASSS‐units less on t+1 in comparison with those not
treated.
In radiographic axial
spondyloarthritis patients, the use of TNF inhibitors minimizes spinal radiographic advancement.
Arthritis & Rheumatology
TNF inhibitors reduce spinal radiographic progression in patients with radiographic axial spondyloarthritis: a longitudinal analysis from the ALBERTA FORCAST cohort
Alexandre Sepriano et al.
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