OP0244 An asas-positive mri of the sacroiliac joints can also occur in healthy individuals, runners and women with postpartum back pain

Winter, J. de; Hooge, M. de; Sande, M. Van de; Jong, Jan de; Hoeven, L. Van; Koning, Anoek de; Berg, I.J.; Ramonda, Roberta; Baeten, Dominique; Heijde, Desirée van der; Weel, A.; Landewé, R. B. M.

doi:10.1136/annrheumdis-2018-eular.5213

Cited by 4 publications

(5 citation statements)

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“…This finding is consistent with another study in healthy individuals, which found the same threshold of ≥5 SIJ quadrants with BME using the same MRI assessment module (31).…”

Section: Accepted Articlesupporting

confidence: 92%

Do Patients With Skin Psoriasis Show Subclinical Axial Inflammation on Magnetic Resonance Imaging of the Sacroiliac Joints and Entire Spine?

Bratu

Häusermann

Walker

et al. 2019

Arthritis Care & Research

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To explore potential subclinical involvement of the axial skeleton by MRI of the sacroiliac joints (SIJ) and entire spine in patients with skin psoriasis without clinical evidence of peripheral or axial inflammation. Methods: Twenty patients with skin psoriasis but no clinical evidence of peripheral or axial inflammation and 22 healthy controls underwent standardized dermatologic and rheumatologic clinical examination and unenhanced 1.5T MRI of the SIJ and the entire spine. Two blinded readers globally assessed the presence or absence of SIJ inflammation simultaneously on T1-weighted and STIR MRI sequences with a confidence estimate. Bone marrow edema, fat metaplasia, erosion and ankylosis of the SIJ, and vertebral Accepted Article This article is protected by copyright. All rights reserved. corner inflammatory and fat lesions were recorded using standardized modules. The prevalence of each lesion type was calculated in both groups averaged across 2 readers. The number of subjects with ≥1/2/3/4/5 lesions in the SIJ and spine as concordantly assessed by both readers was recorded. Results: Median duration of skin psoriasis was 23.0 years, median age of patients 48.5 years. 25.0% of patients and 9.1% of healthy controls were concordantly classified by both readers as having SIJ inflammation (p=0.23). Prevalence of bone marrow edema and structural lesions was comparable across patients and controls both on SIJ and spine MRI. Conclusion: In this controlled study, patients with skin psoriasis, but no clinical arthritis or spondylitis showed limited evidence of concomitant subclinical axial involvement by SIJ and spine MRI. These findings do not support routine screening for subclinical axial inflammation in patients with longstanding skin psoriasis. SIGNIFICANCE AND INNOVATIONS  In this controlled study, MRI of the axial skeleton showed only limited evidence of subclinical axial inflammation in patients with skin psoriasis but without clinical signs of peripheral or axial inflammation.  25% of patients with longstanding skin psoriasis and 9% of healthy controls were concordantly classified by 2 readers as having sacroiliitis. At least 3 spinal corner inflammatory lesions were concordantly reported in 25% of patients and 18% of controls. However, frequencies of inflammatory changes Accepted Article This article is protected by copyright. All rights reserved. on axial MRI showed no statistically significant differences between psoriasis patients and healthy controls (p>0.2).  Our data do not support routine screening for potential subclinical axial inflammation in patients with longstanding skin psoriasis.

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“…This finding is consistent with another study in healthy individuals, which found the same threshold of ≥5 SIJ quadrants with BME using the same MRI assessment module (31).…”

Section: Accepted Articlesupporting

confidence: 92%

Do Patients With Skin Psoriasis Show Subclinical Axial Inflammation on Magnetic Resonance Imaging of the Sacroiliac Joints and Entire Spine?

Bratu

Häusermann

Walker

et al. 2019

Arthritis Care & Research

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“…Regarding the axial skeleton including the spine and the sacroiliac joints (SIJs) this is particularly critical if identification of patients with axial spondyloarthritis (axSpA) is pursued. In this context our study1 confirms earlier data 2. We conclude that false positive MRI findings account for much of the confusion that has been created in relation to the Assessments in Spondyloarthritis International Society (ASAS) classification criteria 3…”

supporting

confidence: 87%

Response to: ‘Frequency of MRI changes suggestive of axial spondyloarthritis in the axial in a large population-based cohort of individuals aged <45 years’ by Parperis

et al. 2020

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“…However, it is important to correctly interpret the MRI changes because it is known that at least some of the changes may also occur in healthy individuals. [2][3][4] "Reference biologics, such as anti-TNF therapy, have been shown to be effective in targeting inflammation, whether in the sacroiliac joints, the spine, or the peripheral joints such as the knee. Within 6-12 months, the inflammation is usually cleared, 5 but in up to 20% of cases, a follow-up MRI may reveal some residual inflammation.…”

Section: Identifying Patients Who Will Benefit Most From Biologic Tre...mentioning

confidence: 99%

“…Several studies [2][3][4] 1). 7 On that basis, therapy should be started as early as necessary to induce remission.…”

Section: Identifying Patients Who Will Benefit Most From Biologic Tre...mentioning

confidence: 99%

Anti-TNF in Rheumatic Diseases: Inventory and Outlook

Bella¹,

Ali²

2018

EMJ Rheumatol

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With an increasing number of biosimilars receiving regulatory approval, the treatment landscape for rheumatic diseases is evolving. Healthcare professionals (HCP) are being presented with an expanding armamentarium of treatment options that can increase patient access to effective biologic therapies and offer an opportunity for healthcare systems to benefit from significant cost savings. In recent years, accumulation of clinical and real-world data with biosimilars has helped physicians gain confidence in the use of biosimilars in daily clinical practice. However, further information regarding best practices of how to effectively introduce biosimilar therapies into a busy clinic is still required. This symposium aimed to uncover various aspects of preparing for a switch, providing suggestions for clinical parameters and imaging tools to aid identification of patients who will respond optimally to biologic treatment. Additionally, HCP–patient communication was analysed from a psychosocial perspective, covering shared decision-making and how to appropriately address common concerns raised by patients. Finally, during this interactive session, country-specific perspectives on best practices for successful switching and the use of remote monitoring tools for patient follow-up were also discussed.

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OP0244 An asas-positive mri of the sacroiliac joints can also occur in healthy individuals, runners and women with postpartum back pain

Cited by 4 publications

References 0 publications

Do Patients With Skin Psoriasis Show Subclinical Axial Inflammation on Magnetic Resonance Imaging of the Sacroiliac Joints and Entire Spine?

Do Patients With Skin Psoriasis Show Subclinical Axial Inflammation on Magnetic Resonance Imaging of the Sacroiliac Joints and Entire Spine?

Response to: ‘Frequency of MRI changes suggestive of axial spondyloarthritis in the axial in a large population-based cohort of individuals aged <45 years’ by Parperis

Anti-TNF in Rheumatic Diseases: Inventory and Outlook

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