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Clinical and MRI findings in ankylosing spondylitis patients eligible for anti-TNF therapy. Response to short-term etoricoxib therapy
  1. Steve J Jarrett (sjardoc{at}aol.com)
  1. University of Leeds, United Kingdom
    1. Francisca Sivera
    1. Department of Rheumatology, Hospital General Universitario of Alicante, Spain
      1. Lorna S Cawkwell
      1. University of Leeds, United Kingdom
        1. Helena Marzo-Ortega (h.marzo-ortega{at}leeds.ac.uk)
        1. University of Leeds, United Kingdom
          1. Dennis G McGonagle (d.g.mcgonagle{at}leeds.ac.uk)
          1. University of Leeds, United Kingdom
            1. Elizabeth Hensor (e.m.a.hensor{at}leeds.ac.uk)
            1. University of Leeds, United Kingdom
              1. Laura Coates (lauraccoates{at}googlemail.com)
              1. University of Leeds, United Kingdom
                1. Philip J O'Connor (philip.o'connor{at}leedsth.nhs.uk)
                1. Department of Radiology, Leeds Teaching Hospitals Trust, United Kingdom
                  1. Alexander Fraser
                  1. University of Leeds, United Kingdom
                    1. Philip G Conaghan (p.conaghan{at}leeds.ac.uk)
                    1. University of Leeds, United Kingdom
                      1. Paul Emery (p.emery{at}leeds.ac.uk)
                      1. University of Leeds, United Kingdom

                        Abstract

                        Objective: To describe and assess the response to short-term etoricoxib in terms of both magnetic resonance imaging (MRI) and clinical variables in AS patients selected for eligibility for anti-TNF therapy.

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

                        Results: Eight out 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 therapy for AS patients; however, 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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