Poor efficacy of TNF inhibitors in non-radiographic axial spondyloarthritis in the absence of objective signs: A bicentric retrospective study.

To compare BASDAI 50 response rate to TNFi in axial spondyloarthritis (axSpA) depending on the presence or not of objective signs of axSpA and to look for predictive factors of TNFi efficacy. Patients diagnosed with axSpA according to ASAS criteria "clinical arm" and treated between January 2001 and September 2015 with TNFi were included. First group included patients with at least one objective sign such as arthritis, dactylitis, enthesitis, uveitis, inflammatory bowel disease, elevated C-reactive protein or radiological sacroiliitis, and second group included non-radiographic axSpA (nr-axSpA) patients without any objective sign corresponding to patients with inflammatory back pain and either a good response to NSAID or a SpA family history. The primary outcome was the TNFi efficacy, defined as an achievement of BASDAI 50 at 3 months. The secondary outcomes were BASDAI 50 achievement over 1 year and analysis of predictive factors of TNFi response. We included 84 nr-axSpA patients without any objective signs and 84 axSpA patients with objective signs (48.2% r-axSpA and 52.8% nr-axSpA). BASDAI 50 achievement rates were significantly higher in patients with objective signs than in patients without, at 3 months (45.1% versus 13.7%, P<0.0001) and at any of the visit-time points over the first year (61.9% versus 21.4%, P<0.0001). In multivariate analysis, overweight/obesity and sacroiliitis on MRI were respectively negative and positive predictive factors of TNFi efficacy in the total population at 3 months (OR=0.32, 95%CI [0.11, 0.96], P=0.041 and OR=6.92, 95% CI (2.41, 19.8), P<0.0001, respectively). TNFi should be used with caution in axSpA when objective signs are absent as only 13.7% of these patients were BASDAI 50 responders at 3 months.

Vidal C ，Lukas C ，Combe B ，Berenbaum F ，Pers YM ，Jorgensen C ，Sellam J ，Morel J ... -  《-》

Tumor Necrosis Factor-α Inhibition in Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis: Treatment Response, Drug Survival, and Patient Outcome.

Corli J ，Flipo RM ，Philippe P ，Bera-Louville A ，Béhal H ，Wibaux C ，Paccou J ... -  《-》

Different drug survival of first line tumour necrosis factor inhibitors in radiographic and non-radiographic axial spondyloarthritis: a multicentre retrospective survey.

Lopalco G ，Venerito V ，Cantarini L ，Emmi G ，Salaffi F ，Di Carlo M ，Tafuri S ，Gentileschi S ，Di Scala G ，Nivuori M ，Cacciapaglia F ，Galeazzi M ，Lapadula G ，Iannone F ... -  《CLINICAL AND EXPERIMENTAL RHEUMATOLOGY》

Ankylosing Spondylitis versus Nonradiographic Axial Spondyloarthritis: Comparison of Tumor Necrosis Factor Inhibitor Effectiveness and Effect of HLA-B27 Status. An Observational Cohort Study from the Nationwide DANBIO Registry.

Glintborg B ，Sørensen IJ ，Østergaard M ，Dreyer L ，Mohamoud AA ，Krogh NS ，Hendricks O ，Andersen LS ，Raun JL ，Kowalski MR ，Danielsen L ，Pelck R ，Nordin H ，Pedersen JK ，Kraus DG ，Christensen SR ，Hansen IM ，Esbesen J ，Schlemmer A ，Loft AG ，Al Chaer N ，Salomonsen L ，Hetland ML ... -  《-》

Comparison of patients with ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA) from a single rheumatology clinic in New Delhi.

Comparison of ankylosing spondylitis (AS) with non-radiographic axial spondyloarthritis (nr-axSpA) classified with the recent ASsessment of spondyloArthritis International Society (ASAS) criteria. This study included 288 patients clinically diagnosed as having spondyloarthritis (SpA) where a satisfactory radiograph of sacroiliac (S-I) joints was available. The AS and the nr-axSpA groups were compared for the various SpA-related variables. Of 288 axSpA patients, there were 187 with AS. Of the remaining 101 patients without radiographic sacroiliitis, S-I joint magnetic resonance imaging (MRI) was available in 72; 54 of them showed active sacroiliitis thus classified as nr-axSpA according to the ASAS criteria. The remaining 18 patients with normal MRI and the other 29 patients without MRI of the S-I joints (total 47 patients), were classified as nr-axSpA using the 'clinical arm' of the ASAS criteria. On comparing the 187 AS with 101 patients in the nr-axSpA group, the AS group showed significantly more males, longer disease duration, more axial symptoms at disease onset, higher Bath Ankylosing Spondylitis Metrology Index and more syndesmophytes. Biologicals were offered significantly more often to the AS group but methotrexate as monotherapy or in combination with other disease-modifying anti-rheumatic drugs was offered more often in nr-axSpA group. There was no statistically significant difference between AS and nr-axSpA in other SpA parameters. The differences brought out between AS and nr-axSpA groups show that they may not be the same disease. A prospective long-term follow-up of large cohorts may help in clarifying if nr-axSpA is simply an early stage in the spectrum of SpA evolving into AS over time or is there inherent difference between them.

Malaviya AN ，Kalyani A ，Rawat R ，Gogia SB ... -  《-》