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Stal R, Sepriano A, Ramiro S, van Gaalen FA, Machado P, Baraliakos X, van den Berg R, Reijnierse M, Braun J, Landewé RBM, van der Heijde D. OP0155 DO FATTY LESIONS EXPLAIN THE ASSOCIATION BETWEEN INFLAMMATION AND NEW SYNDESMOPHYTES IN PATIENTS WITH RADIOGRAPHIC AXIAL SPONDYLOARTHRITIS? Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundPresence of vertebral corner inflammation (VCI) increases the likelihood of a new syndesmophyte in the same vertebral corner (VC) in patients with r-axSpA. It was suggested that subsequent vertebral corner fat deposition (VCFD) partially explains this effect. However, this has not been formally tested.ObjectivesTo determine how much of the effect of VCI on the development of new syndesmophytes is explained by new VCFD.MethodsTwo datasets (SIAS cohort, ASSERT clinical trial) were analyzed. Patients with r-axSpA were assessed at baseline (T0), an intermediate visit (T1) (SIAS: 1 year; ASSERT: 24 weeks) and the end of follow-up (T2) (SIAS: 2 years; ASSERT: 102 weeks). Syndesmophytes were assessed on whole spine low dose CT (SIAS) or spinal radiographs (ASSERT) at T0 and T2 and considered present if seen by 2 of 2 readers. VCI (T0) and VCFD (T0 and T1) on spinal MRI were present if seen by ≥2 of 3 readers (SIAS) or 2 of 2 readers (ASSERT). VCs with VCFD or a syndesmophyte at baseline were excluded. We used the counterfactual approach1 to decompose the total effect of VCI at T0 (binary exposure) on the formation of a new syndesmophyte in the same VC at T2 (binary outcome) into the effect that is explained (natural indirect effect, NIE) and the effect that is not explained (natural direct effect, NDE) by new VCFD (binary mediator) at T1. Because there was no interaction between the exposure and mediator (p=0.88 for SIAS; p=0.82 for ASSERT), the average NIE (aNIE) and average NDE (aNDE) are reported. The aNIE, aNDE and total effect, expressed as absolute increase in risk, were estimated in R using the ‘mediation’ package, which takes into account the 2-level structure of the data (VCs nested within patients).ResultsIn total, 49 patients (2,667 corners) in SIAS and 168 patients (2,918 corners) in ASSERT were included. A new syndesmophyte occurred at T2 in 124/2,667 (5%) corners in SIAS and 91/2,918 (3%) corners in ASSERT (Table 1). New VCFD at T1 was also uncommon (SIAS: 4%; ASSERT: 2%), but occurred more often in corners with (SIAS: 12%; ASSERT: 18%) than without VCI at T0 (SIAS: 3%; ASSERT: 1%). Applying the mediation formula, in SIAS, the presence of VCI at T0 increased the probability of a new syndesmophyte in the same VC at T2 by 9.3% [total effect (95% CI)=9.3% (4.5; 15.0)]. There was only a 0.2% increase in this probability that was mediated by the formation of new VCFDs at T1 [aNIE=0.2% (-0.4; 1.0)]. In contrast, 9.1% of the increase in probability remained unexplained [aNDE=9.1 (4.3; 15.0)]. This means that only 2% (0.2/9.3) of the total effect of VCI on the formation of new syndesmophytes was explained by new VCFD [% mediated=2.0% (-4.1; 13)]. In ASSERT, the total effect was somewhat lower than in SIAS [total effect=7.3% (2.0; 16.0)], and again the aNIE was small [aNIE=0.8% (-0.2; 3.0)], and the aNDE composed most of the total effect [aNDE=6.5% (1.3; 14.0)]. The proportion of the total effect explained by VCFD (0.8/7.3=10% (-3.1;44)) was larger than in SIAS but still non-significant.Table 1.Marginal and conditional probabilitiesSIASVCI T0New VCFD T1New SYND T2nP (SYND|VCI, VCFD)P(VCFD|VCI)0002302P (SYND|0,0) =90/2392= 0.038P(VCFD|0) = 74/2466=0.0300019001070P (SYND|0,1) =4/74 = 0.0540114100152P (SYND|1,0) = 25/177 = 0.141P(VCFD|1) = 24/201 =0.1191012511019P (SYND|1,1) = 5/24 = 0.2081115ASSERTVCI T0New VCFD T1New SYND T2nP (SYND|VCI, VCFD)P(VCFD|VCI)0002660P (SYND|0,0) = 76/2736= 0.028P(VCFD|0) = 35/2771 =0.0130017601034P (SYND|0,1) =1/35= 0.0290111100112P (SYND|1,0) = 9/121= 0.074P(VCFD|1) = 26/147 =0.177101911021P (SYND|1,1) = 5/26 = 0.1921115VCI, vertebral corner inflammation; VCFD, vertebral corner fat deposition; Synd, syndesmophytes; T0, baseline; T1, intermediate visit; T2, end of follow-up; n, number of vertebral corners; P, probabilityConclusionIn these two datasets we see that VCI only infrequently leads to syndesmophyte formation via visible VCFD.References[1]Pearl, The mediation formula, 2011Figure 1.The pathways under study. VCI, vertebral corner inflammation; VCFD, vertebral corner fat depositionDisclosure of InterestsRosalinde Stal: None declared, Alexandre Sepriano Speakers bureau: Novartis, Consultant of: UCB, Sofia Ramiro Speakers bureau: Eli Lilly, MSD, Novartis, UCB, Consultant of: AbbVie, Eli Lilly, MSD, Novartis, Pfizer, UCB, Sanofi, Grant/research support from: AbbVi, Galapagos, MSD, Novartis, Pfizer, UCB, Floris A. van Gaalen Consultant of: Novartis, MSD, AbbVie, Bristol Myers Squibb, Eli Lilly, Grant/research support from: Stichting vrienden van Sole Mio, Stichting ASAS, Jacobus Stichting, Novartis, UCB, Pedro Machado Consultant of: Abbvie, BMS, Celgene, Eli Lilly, Galapagos, Janssen, MSD, Novartis, Orphazyme, Pfizer, Roche and UCB, Xenofon Baraliakos: None declared, Rosaline van den Berg: None declared, Monique Reijnierse Grant/research support from: reader for ASAS CLASSIC study, Juergen Braun: None declared, Robert B.M. Landewé Consultant of: AbbVie, Amgen, BMS, GSK, Janssen, Eli Lilly, Novartis, Pfizer, UCB, Désirée van der Heijde Consultant of: AbbVie, Gilead, Glaxo-Smith-Kline, Lilly, Novartis, UCB Pharma, Grant/research support from: Dutch Rheumatism Association
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Michielsens C, den Broeder N, van den Hoogen F, Mahler E, Teerenstra S, van der Heijde D, Verhoef LM, den Broeder A. OP0261 TREAT-TO-TARGET DOSE REDUCTION AND WITHDRAWAL STRATEGY OF TNF INHIBITORS IN PSORIATIC ARTHRITIS AND AXIAL SPONDYLOARTHRITIS: A RANDOMIZED CONTROLLED NON-INFERIORITY TRIAL. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundTumour Necrosis Factor inhibitors (TNFi) are effective in Psoriatic Arthritis (PsA) and axial SpondyloArthritis (axSpA), but are associated with a somewhat increased infection risk, patient burden, and high costs. Treat-to-target (T2T) tapering might ameliorate these drawbacks, but no high quality T2T tapering studies have been done in PsA and axSpA.ObjectivesTo investigate whether a T2T strategy with tapering is non-inferior to a T2T strategy without tapering.MethodsWe performed a pragmatic open-label, monocenter, randomized, controlled non-inferiority (NI) trial on T2T tapering of TNFi. PsA and axSpA patients using a TNFi with ≥6 months stable low disease activity (LDA) were randomized to a T2T tapering or no-tapering strategy, in a ratio of 2:1 and followed-up for 12 months. LDA was defined as a Psoriatic Arthritis Disease Activity Score (PASDAS) ≤3.2 for PsA and/or Ankylosing Spondylitis Disease Activity Score (ASDAS) <2.1 and/or judgement of physician and patient. Tapering consisted of 3-monthly tapering steps (66%, 50%, 0%), with re-intensification in case of flare. Primary endpoint was the difference in proportion of patients having LDA at 12 months, compared to a prespecified NI margin of 20%. The primary Bayesian analysis was adjusted for stratification factors (diagnosis and csDMARD use). Secondary endpoints included the mean percentage Daily Defined Dose (%DDD) at month 12 and mean 3-monthly disease activity and %DDD. Other endpoints included the proportion of patients discontinuing their TNFi, the cumulative incidence of flares (change from baseline PASDAS≥0.8 or ASDAS≥0.9), the use of concomitant medication and (serious) adverse events.Results122 patients were included (N=81 tapering (PsA, N=42, axSpA, N=39); N=41 no-tapering (PsA, N=22, axSpA, N=19)) (Table 1). Proportion of patients in LDA at 12 months for the tapering and no-tapering group was 69% and 73%: adjusted difference 5% (Bayesian 95% credible interval: -10% to 19%), confirming NI. The mean percentage %DDD was respectively 53% and 91% at month 12 (Figure 1). At 12 months, 58 (72%) patients of the tapering group were successfully tapered, of whom 23 (28%) discontinued their TNFi. The cumulative incidence of flares was 85% in the tapering and 78% in the no-tapering group (p=0.32). Start or escalation of concomitant medication was more frequent in the tapering group, significantly so for NSAID use: csDMARDs (only for PsA): 1 (2%) vs. 1 (5%) (p=0.64); NSAIDs: 44 (54%) vs. 10 (24%) (p=0.002); glucocorticoids: 24 (30%) vs. 7 (17%) (p=0.13). For serious adverse events, similar results were seen. The risks of grade 3/4 infections and injection site reactions were respectively 46% and 23% lower in the tapering group than the no-tapering group.Table 1.Baseline characteristics of T2T strategy treated PsA and axSpA patients with or without tapering.CharacteristicT2T with tapering (N=81)T2T without tapering (N=41)Diagnosis, n (%)-Psoriatic arthritis42(52%)22(54%)-Axial spondyloarthritis39(48%)19(46%)Female, n (%)28(35%)20(49%)Age in years at inclusion, mean (SD)50(14)52(15)Disease duration at inclusion, years, median (IQR)11(5-21)12(5-21)CASPAR Criteria, n (%)34(81%)17(77%)ASAS Criteria, n (%)35(90%)17(89%)Disease activity, mean (SD)-PASDAS - (64/64 PsA)-ASDAS - (57/58 axSpA)1.60(1.26) 1.34(0.87)1.63(0.98) 1.21(0.61)Duration of current bDMARD use, years, median (IQR)2(1-6)2(2-7)Current bDMARD use, n (%)-Adalimumab62(77%)28(68%)-Etanercept10(12%)6(15%)-Certolizumab Pegol2(2%)1(2%)-Golimumab2(2%)1(2%)-Infliximab5(6%)5(12%)Figure 1.Mean disease activity and %DDD of T2T strategy treated PsA (A. and C.) and axSpA (B. and D.) patients with or without tapering at baseline, 3, 6, 9 and 12.ConclusionA T2T TNFi tapering strategy is non-inferior to a T2T strategy without tapering with regard to the proportion of patients still in LDA at 12 months and results in a substantial reduction of TNFi use, albeit with slightly more use of other medication.AcknowledgementsWe thank all the patients who were willing to participate in this study and the rheumatologists in the Sint Maartenskliniek Nijmegen and Woerden for participation in patient recruitment and data collection; S.R. van de Plassche, A.H. Verkerk and M. den Broeder for data collection and entering; M. Roelofs, I. Cillessen, C. Kleinveld, I. van Neste for aiding with study coordination; D. van Aggelen, D. Rotteveel, L. Schiersbergen for aiding with laboratory implementation and procedures; B.J.F. van de Bemt and M. Flendrie for being part of the data safety monitoring board.Disclosure of InterestsCelia Michielsens: None declared, Nathan den Broeder: None declared, Frank van den Hoogen: None declared, Elien Mahler: None declared, Steven Teerenstra: None declared, Désirée van der Heijde Consultant of: AbbVie, Bayer, BMS, Cyxone, Eisai, Galapagos, Gilead, Glaxo-Smith-Kline, Janssen, Lilly, Novartis, Pfizer, UCB Pharma, L.M. Verhoef: None declared, Alfons den Broeder Grant/research support from: Abbvie, Galapagos, Pfizer, Novartis, Lilly, Sanofi, Gilead
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Navarro-Compán V, Boel A, Boonen A, Mease PJ, Dougados M, Kiltz U, Landewé RBM, van der Heijde D. OP0148 THE ASAS CORE MEASUREMENT SET FOR AXIAL SPONDYLOARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundRecently, the core domains of the 20-years old core outcome set for ankylosing spondylitis were updated.1 The next step is to define the measurement core set, which includes at least one instrument for each domain.ObjectivesTo define the instruments for the ASAS-OMERACT core outcome set for axial spondyloarthritis (axSpA).MethodsThe scientific committee invited an international working group representing all key stakeholders (patients, rheumatologists, health professionals and pharmaceutical industry). The instrument selection process is presented in Figure 1.Figure 1.Development process to determine the core measurement setResultsThe updated core measurement set for axSpA is shown in Table 1. This includes seven instruments for six domains that are mandatory for all trials: ASDAS and NRS patient global assessment for disease activity, NRS total back pain for pain, composite index for morning stiffness, NRS fatigue for fatigue, BASFI for physical function, and ASAS Health Index for overall functioning and health. There are 9 additional instruments for disease modifying drugs (DMARDs): two MRI activity scores (SPARCC SIJ and SPARCC spine) for disease activity, the three extra-musculoskeletal manifestations uveitis, IBD and psoriasis assessed as recommended by ASAS2, the three peripheral manifestations (44 swollen joint count, MASES and Dactylitis count2) and mSASSS for structural damage. The imaging outcomes are mandatory to be included at least in one trial for a drug that is considered to be a DMARD. The other instruments specific for DMARDs should be included in every trial. This core set is applicable to patients with radiographic and non-radiographic axSpA. Furthermore, 11 other instruments were also endorsed by ASAS and can additionally be used in axSpA trials: BASDAI, CRP, Berlin MRI-SIJ and MRI-spine activity scores for disease activity, NRS back pain at night for pain, severity (BASDAI Q5) and duration (BASDAI Q6) for morning stiffness, SF-36 for overall functioning and health, 66 swollen joint count and SPARCC enthesitis for peripheral manifestations and MRI-SIJ erosions scores (SPARCC SSS) for structural damage.Table 1.Updated core measurement set for axial spondyloarthritis.Instruments mandatory for all trialsDomainInstrument Disease activityASDASPatient global assessment of disease activity (NRS) PainNRS total back pain (BASDAI Q2) Morning stiffnessSeverity and duration (BASDAI (Q5+Q6)/2)) FatigueNRS fatigue (BASDAI Q1) Physical functionBASFI Overall functioning & healthASAS Health IndexAdditional instruments mandatory for disease modifying drugs trials Disease activitySPARCC MRI-SIJ*SPARCC MRI-spine* Extra-musculoskeletal manifestationsuveitis (ASAS CRF)2psoriasis (ASAS CRF)2inflammatory bowel disease (ASAS CRF)2 Peripheral manifestations44 Swollen joint countMASESDactylitis count (ASAS CRF)2 Structural damagemSASSS**Needs to be assessed at least once in a disease modifying drug programme; 2Dougados M, et al. Ann Rheum Dis 2012;71(6):1103-04. ASDAS: Ankylosing Spondylitis Disease Activity Score; NRS: Numerical Rate Scale; BASDAI: Bath Ankylosing Spondylitis Disease Activity Index; Q: question; BASFI: Bath Ankylosing Spondylitis Functional Index; SPARCC: SpondyloArthritis Research Consortium of Canada Scoring System; MRI: Magnetic Resonance Imaging; SIJ: Sacroiliac Joint; CRF: Case Report Form; MASES: Maastricht Ankylosing Spondylitis Enthesitis Score; mSASSS: modified Stoke Ankylosing Spondylitis Spinal Score.ConclusionThe previous core measurement set has been updated and endorsed by ASAS for the use in all axSpA trials.References[1]Navarro-Compán V, et al. Semin Arthritis Rheum 2021;51(6):1342-49.[2]Dougados M, et al. Annals of the Rheumatic Diseases 2012;71(6):1103-04.AcknowledgementsThe ASAS axSpA core measurement set working group:Désirée van der HeijdeVictoria Navarro CompánAnnelies BoonenPhilip MeaseAnne BoelUta KiltzRobert LandewéMaxime DougadosXenofon BaraliakosWilson BautistaPravina ChiowchanwisawakitYu Heng KwanLianne GenslerBassel El-ZorkanyKarl GaffneyNigel HaroonPedro MachadoWalter MaksymowychAnna MoltoDenis PoddubnyyMikhail ProtopopovSofia RamiroSalima van WeelyMarco Garrido CumbreraNatasha de PeyrecaveLara FallonIn-Ho SongHanne DagfinrudThe Assessment of Spondyloarthritis international Society (ASAS) supported Anne Boel and Victoria Navarro-Compán financially to update the core outcome set.Disclosure of InterestsVictoria Navarro-Compán Speakers bureau: AbbVie, Eli Lilly, Janssen, MSD, Novartis, Pfizer, UCB Pharma, Consultant of: AbbVie, Eli Lilly, MSD, Novartis, Pfizer, UCB Pharma; Research grants from AbbVie and Novartis, Grant/research support from: AbbVie and Novartis, Anne Boel: None declared, Annelies Boonen Speakers bureau: Abbvie / Galapagos, Consultant of: Galapagos, Grant/research support from: AbbVie, Philip J Mease Speakers bureau: Abbvie, Janssen, Lilly, Novartis, Pfizer, UCB, Consultant of: Abbvie, Aclaris, Amgen, Bristol Myers, Boehringer-Ingelheim, Galapagos, Gilead, GlaxoSmithKline, Inmagene, Janssen, Lilly, Novartis, Pfizer, SUN Pharma, UCB, Grant/research support from: Abbvie, Bristol Myers, Gilead, Inmagene, Janssen, Lilly, Novartis, Pfizer, UCB, Maxime Dougados: None declared, Uta Kiltz Consultant of: AbbVie, Chugai, Eli Lilly, Fresenius, Hexal, Janssen, MSD, Novartis, onkowissen.de, Pfizer, Roche and UCB, Grant/research support from: Abbvie, Amgen, Biogen, Hexal, Novartis und Pfizer, Robert B.M. Landewé Consultant of: AbbVie, BMS, Galapagos, Gilead, GSK, Janssen, Lilly, Novartis, Pfizer, UCB, Désirée van der Heijde Consultant of: AbbVie, Bayer, BMS, Cyxone, Eisai, Galapagos, Gilead, Glaxo-Smith-Kline, Janssen, Lilly, Novartis, Pfizer, UCB Pharma, Employee of: Director of Imaging Rheumatology bv.
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Navarro-Compán V, Boel A, Boonen A, Mease P, Landewé R, Kiltz U, Dougados M, Baraliakos X, Bautista-Molano W, Carlier H, Chiowchanwisawakit P, Dagfinrud H, de Peyrecave N, El-Zorkany B, Fallon L, Gaffney K, Garrido-Cumbrera M, Gensler LS, Haroon N, Kwan YH, Machado PM, Maksymowych WP, Poddubnyy D, Protopopov M, Ramiro S, Shea B, Song IH, van Weely S, van der Heijde D. The ASAS-OMERACT core domain set for axial spondyloarthritis. Semin Arthritis Rheum 2021; 51:1342-1349. [PMID: 34489113 DOI: 10.1016/j.semarthrit.2021.07.021] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND The current core outcome set for ankylosing spondylitis (AS) has had only minor adaptations since its development 20 years ago. Considering the significant advances in this field during the preceding decades, an update of this core set is necessary. OBJECTIVE To update the ASAS-OMERACT core outcome set for AS into the ASAS-OMERACT core outcome set for axial spondyloarthritis (axSpA). METHODS Following OMERACT and COMET guidelines, an international working group representing key stakeholders (patients, rheumatologists, health professionals, pharmaceutical industry and drug regulatory agency representatives) defined the core domain set for axSpA. The development process consisted of: i) Identifying candidate domains using a systematic literature review and qualitative studies; ii) Selection of the most relevant domains for different stakeholders through a 3-round Delphi survey involving axSpA patients and axSpA experts; iii) Consensus and voting by ASAS; iv) Endorsement by OMERACT. Two scenarios are considered based on the type of therapy investigated in the trial: symptom modifying therapies and disease modifying therapies. RESULTS The updated core outcome set for axSpA includes 7 mandatory domains for all trials (disease activity, pain, morning stiffness, fatigue, physical function, overall functioning and health, and adverse events including death). There are 3 additional domains (extra-musculoskeletal manifestations, peripheral manifestations and structural damage) that are mandatory for disease modifying therapies and important but optional for symptom modifying therapies. Finally, 3 other domains (spinal mobility, sleep, and work and employment) are defined as important but optional domains for all trials. CONCLUSION The ASAS-OMERACT core domain set for AS has been updated into the ASAS-OMERACT core domain set for axSpA. The next step is the selection of instruments for each domain.
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Affiliation(s)
- V Navarro-Compán
- Rheumatology Service, Hospital Universitario la Paz-IdiPaz, Madrid, Spain
| | - A Boel
- Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands
| | - A Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, the Netherlands and Care and Public Health Research Institute (CAPHRI), Maastricht University, the Netherlands
| | - P Mease
- Division of Rheumatology, Swedish Medical Center/Providence St. Joseph Health and University of Washington, Seattle, WA, USA
| | - R Landewé
- Department of rheumatology & clinical immunology, Amsterdam University Medical Center loc. amC, Amsterdam & Zuyderland MC
- loc. Heerlen, The Netherlands
| | - U Kiltz
- Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Germany
| | - M Dougados
- Université de Paris Department of Rheumatology - Hôpital Cochin. Assistance Publique - Hôpitaux de Paris INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité. Paris, France
| | - X Baraliakos
- Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Germany
| | - W Bautista-Molano
- Rheumatology Department, University Hospital Fundación Santa Fe de Bogotá and School of Medicine Universidad El Bosque. Bogotá, Colombia
| | - H Carlier
- Global Clinical Development Immunology, S.A. Eli Lilly Benelux N.V., Brussels, Belgium
| | | | - H Dagfinrud
- Dept of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | | | | | - L Fallon
- Inflammation and Immunology - Global Medical Affairs, Pfizer Inc, Kirkland, Quebec, Canada
| | - K Gaffney
- Rheumatology Department, Norfolk & Norwich University Hospitals NHS Foundation Trust, Norwich, UH
| | - M Garrido-Cumbrera
- Health & Territory Research (HTR), Universidad de Sevilla, Seville, Spain. Spanish Federation of Spondyloartrhtis Associations (CEADE), Madrid, Spain
| | - L S Gensler
- Division of Rheumatology, Department of Medicine, University of Calfornia, San Francisco, CA, USA
| | - N Haroon
- University of Toronto, Departement of Medicine, University Health Network, Schroder Artritis Institute, Toronto
| | - Y H Kwan
- Program in Health Systems and Services Research, Duke-NUS Medical School, Department of Pharmacy, National University of Singapore, Department of Rheumatology and Immunology, Singapore General Hospital
| | - P M Machado
- Centre for Rheumatology & Department of Neuromuscular Diseases, University College London, London, United Kingdom; National Institute for Health Research (NIHR) University College London Hospitals Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK; Department of Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, United Kingdom
| | - W P Maksymowych
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - D Poddubnyy
- Department of Gastroenterology, Infectious Diseases and Rheumatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - M Protopopov
- Department of Gastroenterology, Infectiology and Rheumatology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Germany
| | - S Ramiro
- Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands; Department of Rheumatology, Zuyderland Medical Center, Heerlen, the Netherlands
| | - B Shea
- Ottawa Hospital Research Institute, School of Epidemiology and Public Health, University of Ottawa, ON, Canada
| | - I H Song
- Immunology Clinical Development, 1 North Waukegan Road Building AP31-2, North Chicago, IL 60064, USA
| | - S van Weely
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, the Netherlands
| | - D van der Heijde
- Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands
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Braun J, Haibel H, de Hooge M, Landewé R, Rudwaleit M, Fox T, Readie A, Richards HB, Porter B, Martin R, Poddubnyy D, Sieper J, van der Heijde D. Spinal radiographic progression over 2 years in ankylosing spondylitis patients treated with secukinumab: a historical cohort comparison. Arthritis Res Ther 2019; 21:142. [PMID: 31174584 PMCID: PMC6555995 DOI: 10.1186/s13075-019-1911-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 05/07/2019] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare radiographic progression in patients with ankylosing spondylitis (AS) treated for up to 2 years with secukinumab (MEASURE 1) with a historical cohort of biologic-naïve patients treated with NSAIDs (ENRADAS). METHODS Baseline and 2-year lateral cervical and lumbar spine radiographs were independently evaluated using mSASSS by two readers, who were blinded to the chronology and cohort of the radiographs. The primary endpoint was the proportion of patients with no radiographic progression (mSASSS change ≤ 0 from baseline to year 2). The Primary Analysis Set included patients with baseline (≤ day 30) and post-baseline day 31-743 radiographs. Sensitivity analyses were performed to assess the robustness of the comparison between the two cohorts, as follows: Sensitivity Analysis Set 1 included all patients with baseline (≤ day 30) and year 2 (days 640-819) radiographs; Sensitivity Analysis Set 2 included all patients with baseline and post-baseline (> day 30) radiographs. RESULTS A total of 168 patients (84%) from the MEASURE 1 cohort and 69 (57%) from the ENRADAS cohort qualified for the Primary Analysis Set. Over 2 years, the LS (SE) mean change from baseline in mSASSS for the primary analysis was 0.55 (0.139) for MEASURE 1 vs 0.89 (0.216) for ENRADAS (p = 0.1852). Mean changes from baseline in mSASSS were lower in MEASURE 1 vs ENRADAS for the primary and sensitivity analyses. The proportion of patients with no radiographic progression was consistently higher in the MEASURE 1 vs ENRADAS cohort across all cutoffs for no radiographic progression (change in mSASSS from baseline to year 2 of ≤ 0, ≤ 0.5, ≤ 1, and ≤ 2), but the differences were not statistically significant. CONCLUSION Secukinumab-treated patients demonstrated a numerical, but statistically non-significant, higher proportion of non-progressors and lower change in mSASSS over 2 years versus a cohort of biologic-naïve patients treated with NSAIDs.
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Affiliation(s)
- J Braun
- Rheumazentrum Herne, Herne, Germany.
| | - H Haibel
- Charité Universitätsmedizin Berlin, Berlin, Germany
| | - M de Hooge
- VIB Inflammation Research Center, Ghent University, Ghent, Belgium
| | - R Landewé
- Maastricht University Medical Center, Maastricht, Netherlands
| | | | - T Fox
- Novartis Pharma AG, Basel, Switzerland
| | - A Readie
- Novartis Pharmaceuticals Corporation, East Hanover, USA
| | | | - B Porter
- Novartis Pharmaceuticals Corporation, East Hanover, USA
| | - R Martin
- Novartis Pharmaceuticals Corporation, East Hanover, USA
| | - D Poddubnyy
- Charité Universitätsmedizin Berlin, Berlin, Germany
| | - J Sieper
- Charité Universitätsmedizin Berlin, Berlin, Germany
| | - D van der Heijde
- VIB Inflammation Research Center, Ghent University, Ghent, Belgium
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6
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Bakker PAC, Ramiro S, Ez-Zaitouni Z, van Lunteren M, Berg IJ, Landewé R, Ramonda R, van Oosterhout M, Reijnierse M, van Gaalen FA, van der Heijde D. Is it Useful to Repeat Magnetic Resonance Imaging of the Sacroiliac Joints After Three Months or One Year in the Diagnosis of Patients With Chronic Back Pain and Suspected Axial Spondyloarthritis? Arthritis Rheumatol 2019; 71:382-391. [PMID: 30203929 PMCID: PMC6593866 DOI: 10.1002/art.40718] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 09/06/2018] [Indexed: 12/14/2022]
Abstract
Objective To investigate the value of repeated magnetic resonance imaging (MRI) of the sacroiliac (SI) joints in diagnosing chronic back pain patients in whom axial spondyloarthritis (SpA) is suspected and to examine determinants of positive MRI findings in SI joints. Methods Patients with chronic back pain (duration 3 months–2 years, age ≥16 years, age at onset <45 years) with ≥1 SpA feature who were included in the Spondyloarthritis Caught Early cohort underwent visits at baseline, at 3 months, and at 1 year. Visits included an evaluation of all SpA features and repeated MRI of SI joints. MRI‐detected axial SpA positivity (according to the definition from the Assessment of SpondyloArthritis international Society) was evaluated by 2 or 3 well‐trained readers who were blinded with regard to clinical information. The likelihood of a positive MRI finding at follow‐up visits (taking into consideration contributing factors) was calculated by generalized estimating equation analysis. Results Of the 188 patients, 38.3% were male, the mean ± SD age was 31.0 ± 8.2 years, and the mean ± SD symptom duration was 13.2 ± 7.1 months. Thirty‐one patients (16.5%) had positive MRI findings in the SI joints at baseline. After 3 months and after 1 year, the MRI results had changed from positive to negative in 3 of 27 patients (11.1%) and 11 of 29 patients (37.9%), respectively, which was attributable in part to the initiation of anti–tumor necrosis factor therapy. Status changes from negative to positive were seen in 5 of 116 patients (4.3%) after 3 months and in 10 of 138 patients (7.2%) after 1 year. HLA–B27 positivity and male sex were independent determinants of the likelihood of a positive MRI scan at any time point (42% in HLA–B27+ men and 6% in HLA–B27− women). If the baseline results were negative, the likelihood of a positive scan at follow‐up was very low (≤7%). Conclusion MRI‐detected status changes in the SI joints were seen in a minority of the patients, and both male sex and HLA–B27 positivity were important predictors of MRI positivity. Our findings indicate that conducting MRI scans after 3 months or after 1 year in patients with suspected early axial SpA is not diagnostically useful.
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Affiliation(s)
- P A C Bakker
- Leiden University Medical Center, Leiden, The Netherlands
| | - S Ramiro
- Leiden University Medical Center, Leiden, The Netherlands
| | - Z Ez-Zaitouni
- Leiden University Medical Center, Leiden, The Netherlands
| | - M van Lunteren
- Leiden University Medical Center, Leiden, The Netherlands
| | - I J Berg
- Diakonhjemmet Hospital, Oslo, Norway
| | - R Landewé
- Amsterdam Medical Rheumatology Center AMC, Amsterdam, The Netherlands, and Atrium Medical CenterHeerlen, The Netherlands
| | | | | | - M Reijnierse
- Leiden University Medical Center, Leiden, The Netherlands
| | - F A van Gaalen
- Leiden University Medical Center, Leiden, The Netherlands
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Kroon FPB, Boersma A, Boonen A, van Beest S, Damman W, van der Heijde D, Rosendaal FR, Kloppenburg M. Performance of the Michigan Hand Outcomes Questionnaire in hand osteoarthritis. Osteoarthritis Cartilage 2018; 26:1627-1635. [PMID: 30099114 DOI: 10.1016/j.joca.2018.07.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 06/27/2018] [Accepted: 07/26/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the performance of the Michigan Hand Outcomes Questionnaire (MHQ) in hand osteoarthritis (OA) by evaluating truth, discrimination and feasibility. DESIGN Symptomatic hand OA patients from the Hand Osteoarthritis in Secondary Care (HOSTAS) cohort completed questionnaires (demographics, MHQ, Australian/Canadian Hand Osteoarthritis Index [AUSCAN], Functional Index for Hand Osteoarthritis [FIHOA] and visual analogue scale [VAS] pain) at baseline (n = 383), 1- and 2-year follow-up (n = 312, n = 293). Anchor questions at follow-up assessed whether pain/function levels were (un)acceptable and had changed compared to baseline. Correlations between MHQ and other pain/function questionnaires were calculated. Validity of unique MHQ domains (work performance, aesthetics, satisfaction), discrimination across disease stages, and responsiveness were assessed by categorizing patients by external anchors (employment, joint deformities, erosions, and anchor questions). Between-group differences were assessed with linear regression, probability plots and comparison of medians. RESULTS MHQ pain and function subscales correlated moderately-to-good with other instruments (rs 0.63-0.81). Work performance scores were worse in patients with reduced working capacity than in employed patients. Aesthetics scores were worse in patients with more deformities. Patients with unacceptable complaints had worse satisfaction scores. All pain/function instruments discriminated between patients with acceptable vs unacceptable pain/function, while only MHQ activities of daily living (ADL), FIHOA, and MHQ aesthetics could discriminate between erosive and non-erosive disease. MHQ and AUSCAN were most responsive. CONCLUSIONS MHQ has several unique aspects and advantages justifying its use in hand OA, including the unique assessment of work performance, aesthetics, and satisfaction. However, MHQ, AUSCAN and FIHOA appear to measure different aspects of pain and function.
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Affiliation(s)
- F P B Kroon
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
| | - A Boersma
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - A Boonen
- Department of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - S van Beest
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - W Damman
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - D van der Heijde
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - F R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - M Kloppenburg
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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Nikiphorou E, Ramiro S, van der Heijde D, Norton S, Moltó A, Dougados M, van den Bosch F, Landewé R. Association of Comorbidities in Spondyloarthritis With Poor Function, Work Disability, and Quality of Life: Results From the Assessment of SpondyloArthritis International Society Comorbidities in Spondyloarthritis Study. Arthritis Care Res (Hoboken) 2018; 70:1257-1262. [DOI: 10.1002/acr.23468] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 11/07/2017] [Indexed: 11/10/2022]
Affiliation(s)
- E. Nikiphorou
- Leiden University Medical Center, Leiden, The Netherlands; and King's College London; London UK
| | - S. Ramiro
- Leiden University Medical Center; Leiden The Netherlands
| | | | | | - A. Moltó
- Paris Descartes University, Hôpital Cochin. Assistance Publique-Hôpitaux de Paris, INSERM (U1153): PRES Sorbonne Paris-Cité; Paris France
| | - M. Dougados
- Paris Descartes University, Hôpital Cochin. Assistance Publique-Hôpitaux de Paris, INSERM (U1153): PRES Sorbonne Paris-Cité; Paris France
| | - F. van den Bosch
- VIB Inflammation Research Center; Ghent University; Ghent Belgium
| | - R. Landewé
- Amsterdam Rheumatology Center, Amsterdam; and Zuyderland MC; Heerlen The Netherlands
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van Erp SJH, Brakenhoff LKMP, Vollmann M, van der Heijde D, Veenendaal RA, Fidder HH, Hommes DW, Kaptein AA, van der Meulen-de Jong AE, Scharloo M. Illness Perceptions and Outcomes in Patients with Inflammatory Bowel Disease: Is Coping a Mediator? Int J Behav Med 2017; 24:205-214. [PMID: 27757843 DOI: 10.1007/s12529-016-9599-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE Patients with inflammatory bowel disease (IBD) often experience severe impairment in different life domains. Psychological factors, such as illness perceptions and coping, may play a role in the adjustment to IBD as indicated by mental and physical health, activity, and work impairment. The present study aimed at examining the assumption of the Common Sense Model (CSM) that coping mediates the relationship between illness perceptions and adjustment in patients with IBD. METHOD In a cross-sectional design, 211 IBD patients (73 % Crohn's disease, 40 % male, mean age 42.9 ± 12.9 years) attending an outpatient clinic completed questionnaires assessing illness perceptions (IPQ-R), coping (CORS), mental and physical health (SF-36), as well as activity and work impairment (WPAI). Multiple mediation analyses were applied that allow estimating the total and direct effects of all illness perception dimensions and the indirect effects through all coping strategies on the illness outcomes simultaneously. RESULTS The analyses yielded significant direct effects of perceptions regarding the cyclical course, the chronic course, the severity of the consequences, the comprehensibility, and the emotional impact of IBD on study outcomes. Additionally, significant indirect effects were found for the perceptions regarding the severity of the consequences, the possibility of personal control, and the comprehensibility of IBD on mental and physical health as well as activity impairment through the use of one specific coping strategy, i.e., reduction of activity. CONCLUSION The results provide evidence for the assumptions of the CSM and suggest the importance of addressing illness perceptions and activity stimulation in quality health care for IBD patients.
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Affiliation(s)
- S J H van Erp
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands
| | - L K M P Brakenhoff
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands
| | - M Vollmann
- Department of Health Psychology, University of Hagen, Hagen, Germany.,Department of Clinical and Health Psychology, University of Utrecht, Utrecht, the Netherlands
| | | | - R A Veenendaal
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands
| | - H H Fidder
- Department of Gastroenterology and Hepatology, UMCU, Utrecht, the Netherlands
| | - D W Hommes
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands.,Center for Inflammatory Bowel Diseases, UCLA Health System, Los Angeles, CA, USA
| | - A A Kaptein
- Department of Medical Psychology, LUMC, Leiden, the Netherlands
| | | | - M Scharloo
- Department of Medical Psychology, LUMC, Leiden, the Netherlands
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Rudwaleit M, Rosenbaum JT, Landewé R, Marzo-Ortega H, Sieper J, van der Heijde D, Davies O, Bartz H, Hoepken B, Nurminen T, Deodhar A. Observed Incidence of Uveitis Following Certolizumab Pegol Treatment in Patients With Axial Spondyloarthritis. Arthritis Care Res (Hoboken) 2017; 68:838-44. [PMID: 26815944 PMCID: PMC5089650 DOI: 10.1002/acr.22848] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 12/07/2015] [Accepted: 01/19/2016] [Indexed: 12/22/2022]
Abstract
Objective Axial spondyloarthritis (axial SpA) is characterized by inflammation of the spine and sacroiliac joints and can also affect extraarticular sites, with the most common manifestation being uveitis. Here we report the incidence of uveitis flares in axial SpA patients from the RAPID‐axSpA trial, including ankylosing spondylitis (AS) and nonradiographic (nr) axial SpA. Methods The RAPID‐axSpA (NCT01087762) trial is double‐blind and placebo‐controlled to week 24, dose‐blind to week 48, and open‐label to week 204. Patients were randomized to certolizumab pegol (CZP) or placebo. Placebo patients entering the dose‐blind phase were re‐randomized to CZP. Uveitis events were recorded on extraarticular manifestation or adverse event forms. Events were analyzed in patients with/without history of uveitis, and rates reported per 100 patient‐years. Results At baseline, 38 of 218 CZP‐randomized patients (17.4%) and 31 of 107 placebo‐randomized patients (29.0%) had past uveitis history. During the 24‐week double‐blind phase, the rate of uveitis flares was lower in CZP (3.0 [95% confidence interval (95% CI) 0.6–8.8] per 100 patient‐years) than in placebo (10.3 [95% CI 2.8–26.3] per 100 patient‐years). All cases observed during the 24‐week double‐blind phase were in patients with a history of uveitis; in these patients, rates were similarly lower for CZP (17.1 [95% CI 3.5–50.1] per 100 patient‐years) than placebo (38.5 [95% CI 10.5–98.5] per 100 patient‐years). Rates of uveitis flares remained low up to week 96 (4.9 [95% CI 3.2–7.4] per 100 patient‐years) and were similar between AS (4.4 [95% CI 2.3–7.7] per 100 patient‐years) and nr‐axial SpA (5.6 [95% CI 2.9–9.8] per 100 patient‐years). Conclusion The rate of uveitis flares was lower for axial SpA patients treated with CZP than placebo during the randomized controlled phase. Incidence of uveitis flares remained low to week 96 and was comparable to rates reported for AS patients receiving other anti–tumor necrosis factor antibodies.
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Affiliation(s)
| | - J T Rosenbaum
- Devers Eye Institute, Legacy Health System, Portland, Oregon, and Oregon Health & Science University, Portland
| | - R Landewé
- Academic Medical Center, Amsterdam and Atrium Medical Center, Heerlen, the Netherlands
| | - H Marzo-Ortega
- Leeds Teaching Hospitals NHS Trust and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - J Sieper
- University Hospital Charité, Berlin, Germany
| | | | | | - H Bartz
- UCB Pharma, Monheim, Germany
| | | | | | - A Deodhar
- Oregon Health & Science University, Portland
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Sepriano A, Ramiro S, van der Heijde D, Ávila-Ribeiro P, Fonseca R, Borges J, Teixeira L, Carvalho PD, Cerqueira M, Neves J, Meirinhos T, Barcelos A, Sequeira G, Salvador MJ, Canas da Silva J, Santos H, Bernardes M, Vieira-Sousa E, Canhão H, Branco JC, Pimentel-Santos F, Landewé R. Effect of Comedication With Conventional Synthetic Disease-Modifying Antirheumatic Drugs on Retention of Tumor Necrosis Factor Inhibitors in Patients With Spondyloarthritis: A Prospective Cohort Study. Arthritis Rheumatol 2017; 68:2671-2679. [PMID: 27273894 DOI: 10.1002/art.39772] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 05/26/2016] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To evaluate whether use of comedication with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) influences the retention of tumor necrosis factor inhibitors (TNFi) in patients with spondyloarthritis (SpA). METHODS Patients with SpA from the Rheumatic Diseases Portuguese Register who started treatment with their first TNFi between 2001 and 2014 were included in this study. Cox regression analysis was used to estimate the effect of comedication with csDMARDs on TNFi retention in 2 types of models: a model in which baseline (time-fixed) variables were included, and a second model incorporating time-varying variables, including sociodemographic features, measures of disease activity, measures of physical function, and cotreatment with other drugs (nonsteroidal antiinflammatory drugs and oral steroids). To control for possible confounding by indication, the effect of csDMARD comedication on TNFi retention was also tested after adjustment for the treatment propensity score. RESULTS In total, 954 patients were included in the study, of whom 289 (30.3%) discontinued treatment with their first TNFi after a median follow-up time of 2.5 years (range 0.08-13 years). Inefficacy was the most common reason for TNFi discontinuation (55.7% of patients). In the multivariable analyses, comedication with csDMARDs had no measurable effect on TNFi retention, neither in the baseline model (hazard ratio [HR] 0.83, 95% confidence interval [95% CI] 0.59-1.16) nor during follow-up in the model adjusted for time-varying covariates (HR 1.07, 95% CI 0.68-1.68). The effect of csDMARD comedication remained nonsignificant after propensity score adjustment. CONCLUSION Comedication with csDMARDs does not prolong TNFi retention in patients with SpA in clinical practice, suggesting that there is no benefit conferred by the concomitant use of these drugs.
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Affiliation(s)
- A Sepriano
- Universidade Nova de Lisboa, Lisbon, Portugal, and Leiden University Medical Center, Leiden, The Netherlands.
| | - S Ramiro
- Universidade Nova de Lisboa, Lisbon, Portugal, and Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - R Fonseca
- Centro Hospitalar São João, Porto, Portugal
| | - J Borges
- Instituto Português de Reumatologia, Lisbon, Portugal
| | - L Teixeira
- Hospital Garcia de Orta, Almada, Portugal
| | - P D Carvalho
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M Cerqueira
- Unidade Local de Saúde do Alto Minho, Ponte de Lima, Portugal
| | - J Neves
- Unidade Local de Saúde do Alto Minho, Ponte de Lima, Portugal
| | | | - A Barcelos
- Hospital Infante D. Pedro, Aveiro, Portugal
| | | | - M J Salvador
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | | | - H Santos
- Instituto Português de Reumatologia, Lisbon, Portugal
| | | | - E Vieira-Sousa
- Lisbon Academic Medical Center and Instituto de Medicina Molecular, Lisbon, Portugal
| | - H Canhão
- Lisbon Academic Medical Center and Instituto de Medicina Molecular, Lisbon, Portugal
| | - J C Branco
- Universidade Nova de Lisboa and Hospital de Egas Moniz-CHLO, Lisbon, Portugal
| | - F Pimentel-Santos
- Universidade Nova de Lisboa and Hospital de Egas Moniz-CHLO, Lisbon, Portugal
| | - R Landewé
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands, and Atrium Medical Center, Heerlen, The Netherlands
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Ez-Zaitouni Z, Bakker PAC, van Lunteren M, Berg IJ, Landewé R, van Oosterhout M, Lorenzin M, van der Heijde D, van Gaalen FA. Presence of multiple spondyloarthritis (SpA) features is important but not sufficient for a diagnosis of axial spondyloarthritis: data from the SPondyloArthritis Caught Early (SPACE) cohort. Ann Rheum Dis 2017; 76:1086-1092. [DOI: 10.1136/annrheumdis-2016-210119] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 11/25/2016] [Accepted: 12/14/2016] [Indexed: 01/24/2023]
Abstract
ObjectivesConcerns have been raised about overdiagnosis of axial spondyloarthritis (axSpA). We investigated whether patients with chronic back pain (CBP) of short duration and multiple SpA features are always diagnosed with axSpA by the rheumatologist, and to what extent fulfilment of the Assessment of SpondyloArthritis International Society (ASAS) axSpA criteria is associated with an axSpA diagnosis.MethodsBaseline data from 500 patients from the SPondyloArthritis Caught Early cohort which includes patients with CBP (≥3 months, ≤2 years, onset <45 years) were analysed. All patients underwent full diagnostic workup including MRI of the sacroiliac joints (MRI-SI) and radiograph of sacroiliac joints (X-SI). For each patient, the total number of SpA features excluding sacroiliac imaging and human leucocyte antigen B27 (HLA-B27) status was calculated.ResultsBefore sacroiliac imaging and HLA-B27 testing, 32% of patients had ≤1 SpA feature, 29% had 2 SpA features, 16% had 3 SpA features and 24% had ≥4 SpA features. A diagnosis of axSpA was made in 250 (50%) of the patients: 24% with ≤1 SpA feature, 43% with 2 SpA features, 62% with 3 SpA features and 85% with ≥4 SpA features. Of the 230 patients with a positive ASAS classification 40 (17.4%) did not have a diagnosis of axSpA. HLA-B27 positivity (OR 5.6; 95% CI 3.7 to 8.3) and any (MRI-SI and/or X-SI) positive imaging (OR 34.3; 95% CI 17.3 to 67.7) were strong determinants of an axSpA diagnosis.ConclusionsIn this cohort of patients with CBP, neither the presence of numerous SpA features nor fulfilment of the ASAS classification criteria did automatically lead to a diagnosis axSpA. Positive imaging was considered particularly important in making a diagnosis of axSpA.
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de Bruin F, ter Horst S, Bloem JL, van den Berg R, de Hooge M, van Gaalen F, Dagfinrud H, van Oosterhout M, Landewé R, van der Heijde D, Reijnierse M. Prevalence and clinical significance of lumbosacral transitional vertebra (LSTV) in a young back pain population with suspected axial spondyloarthritis: results of the SPondyloArthritis Caught Early (SPACE) cohort. Skeletal Radiol 2017; 46:633-639. [PMID: 28236124 PMCID: PMC5355510 DOI: 10.1007/s00256-017-2581-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 01/17/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine in a cohort of young patients with suspected axial spondyloarthritis (axSpA), the prevalence of lumbosacral transitional vertebra (LSTV), its association with local bone marrow edema (BME) and lumbar spine degeneration, and the potential relationship with MRI findings and clinical signs of axSpA. MATERIALS AND METHODS Baseline imaging studies and clinical information of patients from the SPondyloArthritis Caught Early-cohort (back pain ≥3 months, ≤2 years, onset <45 years) were used. Two independent readers assessed all patients for LSTV on radiography, and BME-like and degenerative changes on MRI. Patients with and without LSTV were compared with regard to the prevalence of MRI findings and the results of clinical assessment using Chi-squared test or t test. RESULTS Of 273 patients (35.1% male, mean age 30.0), 68 (25%) patients showed an LSTV, without statistical significant difference between patients with and without axSpA (p = 0.327). Local sacral BME was present in 9 out of 68 (13%) patients with LSTV and absent in patients without LSTV (p < 0.001). Visual analogue scale (VAS) pain score and spinal mobility assessments were comparable. CONCLUSIONS LSTV is of low clinical relevance in the early diagnosis of axSpA. There is no difference between patients with and without LSTV regarding the prevalence of axSpA, pain and spinal mobility, and a BME-like pattern at the pseudoarticulation does not reach the SI joints.
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Affiliation(s)
- F. de Bruin
- Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - S. ter Horst
- Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - J. L. Bloem
- Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - R. van den Berg
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - M. de Hooge
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - F. van Gaalen
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - H. Dagfinrud
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - M. van Oosterhout
- Department of Rheumatology, Groene Hartziekenhuis, Gouda, The Netherlands
| | - R. Landewé
- Department of Rheumatology, Amsterdam Medical Center, Amsterdam, The Netherlands
| | - D. van der Heijde
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - M. Reijnierse
- Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
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Mease P, van der Heijde D, Ritchlin C, Cuchacovich R, Shuler C, Lin CY, Vangerow H, Samanta S, Lee C, Gladman D, Augendre-Ferrante B. Étude de phase 3 de l’ixékizumab versus adalimumab et placebo chez des patients atteints de rhumatisme psoriasique naïfs de DMARDS biologiques. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bakker PAC, Ez-Zaitouni Z, van Lunteren M, van den Berg R, De Hooge M, Fagerli KM, Landewé R, van Oosterhout M, Ramonda R, Reijnierse M, van der Heijde D, van Gaalen FA. Are Additional Tests Needed to Rule Out Axial Spondyloarthritis in Patients Ages 16-45 Years With Short-Duration Chronic Back Pain and Maximally One Spondyloarthritis Feature? Arthritis Care Res (Hoboken) 2016; 68:1726-1730. [DOI: 10.1002/acr.22883] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 02/21/2016] [Accepted: 03/08/2016] [Indexed: 12/13/2022]
Affiliation(s)
| | - Z. Ez-Zaitouni
- Leiden University Medical Center; Leiden The Netherlands
| | | | | | - M. De Hooge
- Leiden University Medical Center; Leiden The Netherlands
| | | | - R. Landewé
- Amsterdam Medical Center, Amsterdam, and Atrium Medical Center; Heerlen The Netherlands
| | | | | | - M. Reijnierse
- Leiden University Medical Center; Leiden The Netherlands
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Kiltz U, van der Heijde D, Boonen A, Bautista-Molano W, Burgos-Vargas R, Chiowchanwisawakit P, Duruoz T, El-Zorkany B, Essers I, Gaydukova I, Géher P, Gossec L, Grazio S, Gu J, Khan MA, Kim TJ, Maksymowych WP, Marzo-Ortega H, Navarro-Compán V, Olivieri I, Patrikos D, Pimentel-Santos FM, Schirmer M, van den Bosch F, Weber U, Zochling J, Braun J. Measuring impairments of functioning and health in patients with axial spondyloarthritis by using the ASAS Health Index and the Environmental Item Set: translation and cross-cultural adaptation into 15 languages. RMD Open 2016; 2:e000311. [PMID: 27752358 PMCID: PMC5051462 DOI: 10.1136/rmdopen-2016-000311] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 09/06/2016] [Accepted: 09/12/2016] [Indexed: 11/28/2022] Open
Abstract
Introduction The Assessments of SpondyloArthritis international society Health Index (ASAS HI) measures functioning and health in patients with spondyloarthritis (SpA) across 17 aspects of health and 9 environmental factors (EF). The objective was to translate and adapt the original English version of the ASAS HI, including the EF Item Set, cross-culturally into 15 languages. Methods Translation and cross-cultural adaptation has been carried out following the forward–backward procedure. In the cognitive debriefing, 10 patients/country across a broad spectrum of sociodemographic background, were included. Results The ASAS HI and the EF Item Set were translated into Arabic, Chinese, Croatian, Dutch, French, German, Greek, Hungarian, Italian, Korean, Portuguese, Russian, Spanish, Thai and Turkish. Some difficulties were experienced with translation of the contextual factors indicating that these concepts may be more culturally-dependent. A total of 215 patients with axial SpA across 23 countries (62.3% men, mean (SD) age 42.4 (13.9) years) participated in the field test. Cognitive debriefing showed that items of the ASAS HI and EF Item Set are clear, relevant and comprehensive. All versions were accepted with minor modifications with respect to item wording and response option. The wording of three items had to be adapted to improve clarity. As a result of cognitive debriefing, a new response option ‘not applicable’ was added to two items of the ASAS HI to improve appropriateness. Discussion This study showed that the items of the ASAS HI including the EFs were readily adaptable throughout all countries, indicating that the concepts covered were comprehensive, clear and meaningful in different cultures.
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Affiliation(s)
- U Kiltz
- Rheumazentrum Ruhrgebiet , Herne , Germany
| | - D van der Heijde
- Department of Rheumatology , Leiden University Medical Center , Leiden , The Netherlands
| | - A Boonen
- Division of Rheumatology, Department of Internal Medicine , Maastricht University Medical Center , Maastricht , The Netherlands
| | - W Bautista-Molano
- Rheumatology Department, Faculty of Medicine , HMC/UMNG , Bogota , Colombia
| | - R Burgos-Vargas
- Department of Rheumatology , Hospital General de Mexico and Universidad Nacional Autonoma de Mexico , Mexico City , Mexico
| | | | - T Duruoz
- PM&R Department, Rheumatology Division , Marmara University, School of Medicine , Istanbul , Turkey
| | - B El-Zorkany
- Rheumatology Department , Cairo University , Cairo , Egypt
| | - I Essers
- Division of Rheumatology, Department of Internal Medicine , Maastricht University Medical Center , Maastricht , The Netherlands
| | - I Gaydukova
- Saratov State Medical University , Saratov , Russian Federation
| | - P Géher
- Semmelweis University , Budapest , Hungary
| | - L Gossec
- Department of Rheumatology , Sorbonne Universités, UPMC Univ, Paris 06, Institut Pierre Louis d'Epidémiologie et de, Santé Publique, GRC-UPMC 08 (EEMOIS); AP-HP,Pitié Salpêtrière Hospital , Paris , France
| | - S Grazio
- Sisters of Mercy University Hospital , Zagreb , Croatia
| | - J Gu
- Department of Rheumatology , The Third Affiliated Hospital of Sun Yat-sen University , Guangzhou , China
| | - M A Khan
- Case Western Reserve University Cleveland , Cleveland, Ohio , USA
| | - T J Kim
- Department of Rheumatology , Chonnam National University Medical School and Hospital , Gwangju , South Korea
| | - W P Maksymowych
- Division of Rheumatology, Department of Medicine , University of Alberta , Edmonton, Alberta , Canada
| | - H Marzo-Ortega
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Alberton Hospital , Leeds , UK
| | | | - I Olivieri
- Rheumatology Department of Lucania , San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera , Potenza , Italy
| | | | - F M Pimentel-Santos
- NOVA Medical School and CEDOC, Chronic Diseases, NOVA University of Lisbon , Lisboa , Portugal
| | - M Schirmer
- Department of Internal Medicine VI , Medical University of Innsbruck , Innsbruck , Austria
| | | | - U Weber
- King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - J Zochling
- Menzies Institute for Medical Research , Hobart, Tasmania , Australia
| | - J Braun
- Rheumazentrum Ruhrgebiet , Herne , Germany
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van der Heijde D, Deodhar A, Fleischmann R, Mease PJ, Rudwaleit M, Nurminen T, Davies O. Early Disease Activity or Clinical Response as Predictors of Long-Term Outcomes With Certolizumab Pegol in Axial Spondyloarthritis or Psoriatic Arthritis. Arthritis Care Res (Hoboken) 2016; 69:1030-1039. [PMID: 27696727 PMCID: PMC5518306 DOI: 10.1002/acr.23092] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 07/21/2016] [Accepted: 09/13/2016] [Indexed: 01/17/2023]
Abstract
Objective Early identification of patients unlikely to achieve good long‐term disease control with anti–tumor necrosis factor therapy in axial spondyloarthritis (SpA) and psoriatic arthritis (PsA) is important for physicians following treat‐to‐target recommendations. Here we assess associations between disease activity or clinical response during the first 12 weeks of treatment and attainment of treatment targets at week 48 in axial SpA and PsA patients receiving certolizumab pegol. Methods The relationship between disease activity or clinical response during the first 12 weeks of treatment and achievement of week‐48 targets (for axial SpA: inactive disease based on Ankylosing Spondylitis Disease Activity Score [ASDAS] using the C‐reactive protein [CRP] level, or Bath Ankylosing Spondylitis Disease Activity Index <2 with normal CRP level; and for PsA: minimal disease activity) was assessed post hoc using RAPID‐axSpA and RAPID‐PsA trial data. Results A clear relationship between disease activity from week 2 to 12 and achievement of week‐48 treatment targets was observed in both axial SpA and PsA populations. In axial SpA, week‐48 ASDAS inactive disease was achieved by 0% of patients (0 of 21) with ASDAS very high disease activity at week 12, compared to 68% of patients (34 of 50) with week‐12 ASDAS inactive disease. For PsA, week‐48 minimal disease activity was achieved by 0% of patients (0 of 26) with Disease Activity Score in 28 joints (DAS28) using the CRP level >5.1 at week 12, compared to 73% of patients (57 of 78) with DAS28‐CRP <2.6. Similar results were observed regardless of the disease activity measure used. Clinical response at week 12 also predicted week‐48 outcomes, though to a lesser extent than disease activity. Conclusion Using disease activity and the clinical response state during the first 12 weeks of certolizumab pegol treatment, it was possible to identify a subset of axial SpA and PsA patients unlikely to achieve long‐term treatment goals.
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Affiliation(s)
| | - A Deodhar
- Oregon Health and Science University, Portland
| | | | - P J Mease
- Swedish Medical Center and University of Washington, Seattle
| | - M Rudwaleit
- Klinikum Bielefeld and Charité Berlin, Berlin, Germany, and Ghent University, Ghent, Belgium
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Emery P, Bingham CO, Burmester GR, Bykerk VP, Furst DE, Mariette X, Heijde DVD, Vollenhoven RV, Arendt C, Mountian I, Purcaru O, Tatla D, VanLunen B, Weinblatt ME. Response to: 'Let's stop fooling ourselves. In RA, only ACR/EULAR criteria define remission and equate with absence of disease!' by Boers. Ann Rheum Dis 2016; 75:e69. [PMID: 27519773 DOI: 10.1136/annrheumdis-2016-210083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 07/03/2016] [Indexed: 11/03/2022]
Affiliation(s)
- P Emery
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - G R Burmester
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - V P Bykerk
- Weill Cornell Medical College, Division of Rheumatology, Hospital for Special Surgery, New York, USA
| | - D E Furst
- Division of Rheumatology, David Geffen School of Medicine at UCLA, Los Angeles, USA
| | - X Mariette
- Université Paris-Sud, Hôpitaux Universitaires Paris-Sud, AP-HP, INSERM U1184, Le Kremlin Bicêtre, France
| | | | - R van Vollenhoven
- Unit for Clinical Therapy Research, Inflammatory Disease, Karolinska Institute, Stockholm, Sweden
| | | | | | | | | | | | - M E Weinblatt
- Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, USA
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Castillo-Ortiz JD, Ramiro S, Landewé R, van der Heijde D, Dougados M, van den Bosch F, Boonen A. Work Outcome in Patients With Ankylosing Spondylitis: Results From a 12-Year Followup of an International Study. Arthritis Care Res (Hoboken) 2016; 68:544-52. [PMID: 26414460 DOI: 10.1002/acr.22730] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Revised: 08/11/2015] [Accepted: 09/08/2015] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To understand the impact of ankylosing spondylitis (AS) on work disability (WD) over 12 years compared with the general population, and explore factors predicting adverse work outcome, defined as new partial WD or reduction in working hours. METHODS Source of data was the Outcome Assessments in Ankylosing Spondylitis International Study, which includes patients from The Netherlands, France, and Belgium. Standardized WD rates over time compared to the general population were calculated using indirect standardization (Dutch patients only). Cox survival analyses identified baseline predictors as well as time-varying factors influencing adverse work outcome over 12 years. RESULTS Of 215 patients, 55 (26%) were full WD at baseline and 139 (65%) were at risk for adverse work outcome during followup. When compared to the general population, WD over 12 years continued to be increased in Dutch men (incidence rate [IR] 2.9 [95% confidence interval (95% CI) 1.2, 4.6]), but less clearly for women (IR 1.2 [95% CI -0.4, 2.9]). Within the entire sample, baseline predictors of adverse work outcome over 12 years were residence in The Netherlands (versus France or Belgium) (hazard ratio [HR] 3.4 [95% CI 1.4, 8.4]) and worse Bath Ankylosing Spondylitis Functional Index (BASFI) (HR 1.2 [95% CI 1.0, 1.4]). Time-varying predictors over 12 years were residence in The Netherlands, uveitis, and either BASFI or Bath Ankylosing Spondylitis Disease Activity Index with age and inflammatory bowel disease. CONCLUSION Although WD was already prevalent at inclusion in the cohort, a substantial proportion of patients incurred further adverse work outcome over 12 years. In addition to country of residence, uveitis, age, and self-reported physical function or disease activity predicted long-term adverse work outcome.
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Affiliation(s)
- J D Castillo-Ortiz
- Maastricht University, Maastricht, The Netherlands, and Unidad de Investigacion en Enfermedades Cronico Degenerativas, Guadalajara, Jalisco, Mexico
| | - S Ramiro
- Amsterdam Rheumatology Center, Amsterdam, The Netherlands, and Hospital Garcia de Orta, Almada, Portugal
| | - R Landewé
- Hospital Garcia de Orta, Almada, Portugal, and Atrium Medical Center, Heerlen, The Netherlands
| | | | | | | | - A Boonen
- Maastricht University, Maastricht, The Netherlands
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Emery P, Bingham C, Burmester GR, Bykerk V, Furst D, Mariette X, van der Heijde D, van Vollenhoven R, VanLunen B, Ecoffet C, Cioffi C, Weinblatt M. OP0227 A Randomized Double-Blind Treatment Strategy Study Evaluating Continuation or Reduced-Frequency Dosing of Certolizumab Pegol versus Withdrawal To Maintain Low Disease Activity in Early RA Patients (C-Early Period 2). Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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van der Heijde D, Deodhar A, Wei J, Drescher E, Fleishaker D, Hendrikx T, Li D, Menon S, Kanik K. OP0002 Tofacitinib in Patients with Ankylosing Spondylitis: A Phase 2, 16-Week, Randomised, Placebo-Controlled, Dose-Ranging Study. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1847] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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van der Heijde D, van Adelsberg J, Fay J, van Hoogstraten H, Mangan E, Graham N, Fan C, Spindler A, Genovese M. SAT0160 Clinical and Radiographic Outcomes after 2 Years of Sarilumab in Patients with Rheumatoid Arthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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van der Heijde D, Dougados M, Landewé R, Sieper J, Maksymowych W, Rudwaleit M, van den Bosch F, Braun J, Mease P, Davies O, Hoepken B, Peterson L, Deodhar A. SAT0375 Certolizumab Pegol for The Treatment of Axial Spondyloarthritis: 4-Year Outcomes from The Rapid-AXSPA Trial. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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van der Heijde D, Fan C, van Hoogstraten H, Mangan E, van Adelsberg J, Miranda P, Genovese M. SAT0058 Consistency of Radiographic Responses with Sarilumab plus Methotrexate across Subpopulations of Patients with Rheumatoid Arthritis in A Phase 3 Study. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Atsumi T, Yamamoto K, Takeuchi T, Yamanaka H, Ishiguro N, Tanaka Y, Eguchi K, Watanabe A, Origasa H, Shoji T, Togo O, Okada T, van der Heijde D, Miyasaka N, Koike T. THU0157 Clinical Outcomes at Week 104 and Analysis of Associated Baseline Factors after An Initial 1 Year of Certolizumab Pegol and MTX Treatment in MTX-Naïve Patients with Early RA: Results from The Second Year of The C-Opera Study. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ez-Zaitouni Z, van Lunteren M, Bakker P, Reijnierse M, Berg I, Landewé R, van Oosterhout M, Ortolan A, van der Heijde D, van Gaalen F. THU0382 Development of SPA-Features in Patients with Chronic Back Pain over A One-Year Course: Data from The Spondyloarthritis Caught Early (Space)-Cohort. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Sundlisater N, Lillegraven S, Olsen I, Aga AB, Hammer H, Uhlig T, van der Heijde D, Kvien T, Haavardsholm E. OP0119 Predictors of Radiographic Progression in Early Rheumatoid Arthritis Patients Treated by An Aggressive Tight Control Regime: Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kiltz U, van der Heijde D, Boonen A, Braun J. OP0084 Validation of The Asas Health Index: Results of A Multicenter International Study in 23 Countries: Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ramiro S, Landewé R, van der Heijde D, FitzGerald O, Østergaard M, Homik J, Elkayam O, Thorne J, Larche M, Ferraccioli G, Backhaus M, Boire G, Combe B, Schaeverbeke T, Saraux A, Dougados M, Adami S, Govoni M, Sinigaglia L, Cantagrel A, Allaart C, Barnabe C, Bingham C, Tak P, van Schaardenburg D, Hammer H, Dadashova R, Hutchings E, Paschke J, Maksymowych W. THU0067 Is Treat-To-Target Really Working? A Longitudinal Analysis in Biodam. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mease P, Fleischmann R, Wollenhaupt J, Deodhar A, Gladman D, Hoepken B, Peterson L, van der Heijde D. FRI0472 Improvements in Joint Outcomes of Psoriatic Arthritis over 4 Years of Treatment with Certolizumab Pegol in Patients with and without Prior Anti-TNF Exposure. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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van der Heijde D, Dougados M, Maksymowych W, Braun J, Bergman G, Curtis S, Tzontcheva A, Philip G, Huyck S, Sieper J. SAT0388 Long-Term Efficacy and Tolerability of Golimumab in Active Nonradiographic Axial Spondyloarthritis: Results of The Open-Label Extension of A Randomized, Double-Blind Study. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Fongen C, Dagfinrud H, Berg I, Ramiro S, van Gaalen F, Landewé R, Ramonda R, van Oosterhout M, van der Heijde D, Fagerli K. OP0154-HPR Spinal Mobility Is Impaired in Patients with Chronic Back Pain of Short Duration, but Does Not Discriminate between Patients with Axial Spondyloarthritis and Other Forms of CBP: Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sepriano A, Ramiro S, van der Heijde D, Άvila-Ribeiro P, Fonseca R, Borges J, Teixeira L, Carvalho P, Cerqueira M, Neves J, Meirinhos T, Barcelos A, Sequeira G, Salvador M, Canas da Silva J, Santos H, Bernardes M, Vieira-Sousa E, Canhão H, Branco J, Pimentel-Santos F, Landewé R. OP0112 Effect of Comedication with Conventional Synthetic Dmards on Tnf Inhibitors-Retention in Patients with Spondyloarthritis: A Prospective Cohort. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Van Lunteren M, Bakker P, Ez-Zaitouni Z, van der Vijver J, Fongen C, Landewé R, van Oosterhout M, Ramonda R, van Gaalen F, van der Heijde D. THU0409 Is Disease Activity Associated with Work Productivity Loss, Presenteeism, and Absenteeism in Patients with Early Axial Spondyloarthritis? Results from The Space Cohort. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Putrik P, Ramiro S, Moltό A, Keszei A, Dougados M, van der Heijde D, Landewé R, Boonen A. OP0089 Are Individual or Country Level Socio-Economic Determinants Related To Disease Activity and Self-Reported Physical Function in Patients with Spondyloarthritis? Results from Multi-National Cross-Sectional Study Asas-Comospa: Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Taylor P, Keystone E, Tanaka Y, van der Heijde D, Zhong J, Thanabalasundrum S, Ruotolo G, Schlichting D, Rooney T, Macias W, Zuckerman S, de Bono S, Weinblatt M. THU0198 Baricitinib Effects on Lipid and NMR-Measured Lipoprotein Profiles in A Phase 3 Study in Patients with Rheumatoid Arthritis:. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Maksymowych W, Dougados M, Sieper J, Braun J, Bergman G, Curtis S, Tzontcheva A, Philip G, Huyck S, van der Heijde D. SAT0423 Patient-Reported Quality of Life in Patients with Baseline Objective Signs of Inflammation and Active Nonradiographic Axial Spondyloarthritis Treated with Golimumab: Results of The Open-Label Extension of A Randomized, Double-Blind Study. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Van Lunteren M, Bakker P, Scharloo M, Kaptein A, Ez-Zaitouni Z, Fongen C, Landewé R, van Oosterhout M, Lorenzin M, van Gaalen F, van der Heijde D. FRI0404 Illness Perceptions and Health-Related Quality of Life in Patients with Axial Spondyloarthritis and Other Forms of Chronic Back Pain in The Space-Cohort. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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van der Heijde D, Simon J, van Hoogstraten H, Mangan E, Fay J, van Adelsberg J, Fan C, Genovese M. SAT0149 Radiographic Outcomes in Patients Achieving Clinical Remission or Low Disease Activity in A Phase 3 Study of Sarilumab plus Methotrexate in Patients with Active, Moderate-To-Severe Rheumatoid Arthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sieper J, van der Heijde D, Maksymowych W, Braun J, Bergman G, Curtis S, Tzontcheva A, Philip G, Huyck S, Dougados M. SAT0399 Efficacy of Golimumab for Nonradiographic Axial Spondyloarthritis: Subgroup Analysis by Baseline MRI and C-Reactive Protein Status: Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Mariette X, Bingham C, Burmester GR, Bykerk V, Emery P, Furst D, van der Heijde D, van Vollenhoven R, VanLunen B, Arendt C, Weinblatt M. THU0163 Early Response as A Predictor of Long-Term Clinical Response in DMARD-Naïve Patients with Severe, Active and Progressive RA Treated with Certolizumab Pegol plus Optimized MTX versus Optimized MTX Alone. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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De Winter J, van Mens L, van der Heijde D, Landewé R, Baeten D. THU0376 Prevalence of Peripheral and Extra-Articular Disease in Ankylosing Spondylitis versus Non-Radiographic Axial Spondyloarthritis: A Meta-Analysis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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43
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Humby F, Dicicco M, Kelly S, Bombardieri M, Hands R, Rocher V, Zou L, Myles L, Blighe K, Ng N, Ramamoorthi N, Hackney J, Zuckerman N, Townsend M, Landewe R, Van der Helm van Mihl A, van der Heijde D, Buckely C, Taylor P, McInnes I, Pitzalis C. OP0240 Synovial Lymphocytic Aggregates Associate with Highly Active RA and Predict Erosive Disease Progression at 12 Months: Results from The Pathobiology of Early Arthritis Cohort. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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44
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Van Lunteren M, Scharloo M, Kaptein A, Ez-Zaitouni Z, Bakker P, Fongen C, Landewé R, van Oosterhout M, Lorenzin M, van Gaalen F, van der Heijde D. THU0410 The Association between Disease Activity and Iillness Perceptions in Early Axial Spondyloarthritis Patients in The Spondyloarthritis Caught Early (Space)-Cohort. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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45
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Gross J, Ramiro S, Etcheto A, Molto A, Van Tubergen A, Landewée R, van der Heijde D, Dougados M, Miceli-Richard C. AB0692 Parameters Associated with Severe Axial Structural Involvement: Data from The Bamboo Spine Cohort on 133 Spondyloarthritis Patients. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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46
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Strand V, Kavanaugh A, Kivitz A, van der Heijde D, Kwok K, Akylbekova E, Soonasra A, Snyder M, Connell C, Bananis E, Smolen J. THU0165 Long-Term Radiographic and Patient-Reported Outcomes Based on Clinical Disease Activity Index Responses with Tofacitinib at 6 Months. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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47
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de Hooge M, de Bruin F, de Beer L, Bakker P, van den Berg R, Ramiro S, van Gaalen F, Fagerli K, Landewé R, van Oosterhout M, Ramonda R, Huizinga T, Bloem J, Reijnierse M, van der Heijde D. OP0090 Mri Lesions Originating from either Axspa or Degeneration Are Related To Site of Pain in Patients with Chronic Back Pain Included in The Space-Cohort. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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48
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van der Heijde D, Braun J, Rudwaleit M, Landewé R, Purcaru O, Kavanaugh A. SAT0389 Long-Term Improvements in Workplace and Household Productivity and Social Participation over 4 Years of Certolizumab Pegol Treatment in Patients with Axial Spondyloarthritis, Including Ankylosing Spondylitis and Non-Radiographic Axial Spondyloarthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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49
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Sundlisater N, Lillegraven S, Aga AB, Olsen I, Uhlig T, Hammer H, van der Heijde D, Kvien T, Haavardsholm E. FRI0090 BMI and Tender Joints Are Predictors of Not Reaching Sustained Remission in Patients Participating in An Aggressive Treat-To-Target Study: Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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50
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van der Heijde D, Dougados M, Chen YC, Greenwald M, Drescher E, Klar R, Xie L, de la Torre I, Rooney T, Witt S, Schlichting D, DeBono S, Emery P. THU0168 Baricitinib Inhibits Radiographic Progression of Structural Joint Damage at 1 Year in Patients with Rheumatoid Arthritis (RA) and An Inadequate Response To csDMARDs:. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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