Background Spondyloarthities primarily manifest in the axial skeleton, with a majority of patients having manifestations in the sacroiliac (SI) joints.
Objectives To assess the efficacy of TNF inhibitors in reducing sacroiliac (SI) joint progression in patients with Axial Spondyloarthities (AS)
Methods AS patients (satisfying ASAS criteria 2009) with at least two sets of Antero-posterior X-rays of the pelvis at a minimum gap of 2 years were included and were divided into two groups: Group1: received TNF-inhibitors and group 2 received non-steroidal antiinflammatory and/or scDMARDs. Radiographic severity was assessed by Forrestier classification at beseline, at 2years and after an average of 5 years. Patients with grade 4 SI joints were excluded. Bath AS Disease Activity Index (BASDAI), BASFI, ESR, CRP, HLA-B27 and age of onset were included in the model
Results Group 1 included 46 patients. The median age of onset of the disease was 25 years [16-49ans], HLA B27 was positive in 53% of cases. The median BASDAI and BASFI scores were respectively 5,8 and 5,4. The average ESR and CRP were respectively 49 and 35. Patients received Infliximab 48%, Adalimumab 14% and Etanercept 36%. Twenty two patients received csDMARDs and 24 NSAID. The mean SI joint grade at baseline was 3. Sixty four percent of patients had SI joint grade 3 and 36% had SI joint grade2. Group 2 included 38 patients. There were no significant differences between the two groups for the mean age of onset, the mean CRP and ESR level and SI joint grade at baseline, however BASDAI and BASFI scores at baseline were significantly higher in Group1. In the group of study 30% of patients with SI joint grade 3 progressed to grade 4 and 22% o of patients with SI joint grade2 progressed to grade 3.There were no significant difference between the two groups
Conclusions TNF inhibitors do not seem to prevent radiographic progression of the sacroiliac joints.
Disclosure of Interest None declared