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Bispebjerg Hospital - a part of Copenhagen University Hospital

Course of Magnetic Resonance Imaging-Detected Inflammation and Structural Lesions in the Sacroiliac Joints of Patients in the Randomized, Double-Blind, Placebo-Controlled Danish Multicenter Study of Adalimumab in Spondyloarthritis, as Assessed by the Berlin and Spondyloarthritis Research Consortium of Canada Methods.

Research output: Contribution to journalJournal articleResearchpeer-review

  • Susanne J Pedersen
  • Denis Poddubnyy
  • Inge J Sørensen
  • Anne-Gitte Loft
  • Jens Hindrup
  • Gorm Thamsborg
  • Karsten Asmussen
  • Oliver Hendricks
  • Jesper Nørregaard
  • Anne-Dorthe Piil
  • Jakob M Møller
  • Anne-Grethe Jurik
  • Lone Balding
  • Robert G Lambert
  • Joachim Sieper
  • Mikkel Østergaard
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OBJECTIVES: To investigate changes in MRI inflammation and structural lesions in the sacroiliac joints (SIJ) during treatment with adalimumab (ADA) vs. placebo (PLA).

METHODS: In a 48-week double-blind placebo-controlled trial, 52 SpA patients were randomized to sc. ADA 40 mg (n=25) or PLA for 12 weeks, followed by ADA (n=27) eow. SIJ MRIs obtained at weeks 0, 12, 24 and 48 were assessed independently and blindly by use of the modified Berlin and Spondyloarthritis Research Consortium of Canada (SPARCC) SIJ MRI Inflammation and Structural Scores.

RESULTS: No baseline inflammation was observed in 44% of the ADA-group and 26-30% of the PLA-group. In patients having baseline inflammation, larger mean percentage reductions in MRI inflammation from week 0 to 12 were seen in ADA-group than PLA-group (Berlin/SPARCC: -52%/-58% vs -5%/-12%, both p<0.05). Furthermore, SPARCC erosion score decreased (mean -0.6) and SPARCC backfill score increased (+0.8) in ADA-group. From week 12 to 24, larger absolute reductions in Berlin/SPARCC inflammation scores and SPARCC erosion score, and larger increases in Berlin/SPARCC fat scores were seen in PLA-group than ADA-group. In univariate regression analyses (ANCOVA) and multivariate stepwise regression analyses treatment with adalimumab was independently associated with regression of SPARCC erosion score from week 0 to 12, but not with changes in the other types of MRI lesions.

CONCLUSION: Significant changes in Berlin and SPARCC MRI inflammation scores and in SPARCC erosion score occurred within 12 weeks after initiation of adalimumab. TNFα-inhibitor treatment was associated with resolution of erosion and development of backfill. This article is protected by copyright. All rights reserved.

Original languageEnglish
JournalArthritis & rheumatology
Issue number2
Pages (from-to)418-29
Publication statusPublished - 2016

ID: 45788894