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MRI and clinical findings in patients with ankylosing spondylitis eligible for anti-tumour necrosis factor therapy after a short course of etoricoxib
  1. S J Jarrett1,
  2. F Sivera2,
  3. L S Cawkwell1,
  4. H Marzo-Ortega1,
  5. D McGonagle1,
  6. E Hensor1,
  7. L Coates1,
  8. P J O’Connor3,
  9. A Fraser1,
  10. P G Conaghan1,
  11. P Emery1
  1. 1
    University of Leeds, Leeds, UK
  2. 2
    Department of Rheumatology, Hospital General Universitario of Alicante, Alicante, Spain
  3. 3
    Department of Radiology LTHT, Leeds, UK
  1. Correspondence to Professor P Emery, Academic Section of Musculoskeletal Disease, Second Floor, Chapel Allerton Hospital, Chapeltown Road, Leeds LS7 4SA, UK; p.emery{at}leeds.ac.uk

Abstract

Objective: To describe and assess the response to short-term etoricoxib as shown by MRI and clinical variables in patients with ankylosing spondylitis (AS) selected for eligibility for anti-tumour necrosis factor therapy.

Methods: In a 6-week open-label study, 22 patients with AS and eligible for biological therapy were treated with 90 mg of etoricoxib daily. Clinical and laboratory parameters were obtained and MRI of the sacroiliac joints and the lower thoracic and lumbar spine performed at baseline and at week 6. The primary end point was the proportion of patients fulfilling the SpondyloArthritis international Society (ASAS) response criteria for biological therapies (ASASBIO) while secondary end points included the change in MRI-determined bone lesions.

Results: Eight of 20 completers improved enough to meet the ASASBIO response criteria and most clinical variables improved significantly. Fifteen patients had a total of 63 MRI-detectable lesions; overall, 13/60 lesions with paired scans either resolved completely or improved, while five lesions worsened or appeared during treatment.

Conclusion: Etoricoxib is an effective symptomatic treatment for patients with AS; however, its effect on MRI-detected lesions is small. Further studies are needed to determine the effect of etoricoxib on MRI-determined bone oedema.

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Footnotes

  • SJJ and FS are joint first authors.

  • Funding This study was supported by an unrestricted educational grant from MSD UK. PGC is partially supported by a grant from ARC UK. FS was a Pfizer articulum fellow.

  • Competing interests None.

  • Ethics approval Approved by the local ethics committee.

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