Critical appraisal of assessment of structural damage in ankylosing spondylitis: Implications for treatment outcomes

The Impact of Body Mass Index on Disease Progression in Ankylosing Spondylitis

“…Thus, BMI can be used as an objective indirect evaluation of the severity of systemic inflammation and/or the consequence of it expressed by functional disability and spinal mobility impairment. Reversible spinal inflammation causes irreversible structural damage leading to spinal mobility impairment and functional disability (Sieper et al, 2008). Interestingly, data obtained from the Korean College of Rheumatology BIOlogics registry revealed that increased BMI is significantly associated with the presence of syndesmophyte, but not with disease activity in axial spondyloarthritis (SpA) (Kim et al, 2017).…”

In Situ Analysis of Interleukin–23– and Interleukin‐12–Positive Cells in the Spine of Patients With Ankylosing Spondylitis

“…The burden of the disease is dependent on the degree of acute inflammation causing pain and stiffness and on new bone formation causing a reduction in spinal mobility (1)(2)(3)(4).…”

Magnetic Resonance Imaging — Key to Understanding and Monitoring Disease Progression in Spondyloarthritis?

“…The impressive effect of tumor necrosis factor (TNF) inhibitors on disease activity without any apparent effect on structural damage progression as assessed by the standard measure (radiography) has fueled this interest 1,2 . Is the link between inflammation and damage nonexistent?…”