TY - JOUR T1 - Treatment with tumour necrosis factor inhibitors is associated with a time-shifted retardation of radiographic spinal progression in patients with axial spondyloarthritis JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - 1252 LP - 1259 DO - 10.1136/annrheumdis-2022-222324 VL - 81 IS - 9 AU - Murat Torgutalp AU - Valeria Rios Rodriguez AU - Ani Dilbaryan AU - Fabian Proft AU - Mikhail Protopopov AU - Maryna Verba AU - Judith Rademacher AU - Hildrun Haibel AU - Joachim Sieper AU - Martin Rudwaleit AU - Denis Poddubnyy Y1 - 2022/09/01 UR - http://ard.bmj.com/content/81/9/1252.abstract N2 - Objective The objective of the current study was to analyse the association between treatment with tumour necrosis factor inhibitors (TNFi) and radiographic spinal progression in patients with axial spondyloarthritis (axSpA) from a long-term inception cohort.Methods A total of 243 patients with axSpA from the German Spondyloarthritis Inception Cohort with at least two sets of spinal radiographs obtained at least 2 years apart during a 10-year follow-up were included. Spinal radiographs were evaluated by three trained and calibrated readers according to the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). The association between the current TNFi, previous TNFi and radiographic spinal progression defined as the absolute mSASSS change score over 2 years was analysed using longitudinal generalised estimating equations analysis.Results TNFi treatment in the current 2-year interval was not associated with retardation of radiographic spinal progression (β=−0.02 (95% CI −0.37 to 0.34) and −0.17 (95% CI −0.54 to 0.20) for any and ≥12 months treatment duration, respectively, adjusted for sex, the Ankylosing Spondylitis Disease Activity Score, smoking, presence of definite radiographic sacroiliitis, mSASSS at baseline and non-steroidal anti-inflammatory drug intake). TNFi treatment in the previous 2-year interval, was, however, significantly associated with reduction of mSASSS progression, which was especially evident in patients who received TNFi in the previous and in the current intervals: β=−0.58 (95% CI −1.02 to –0.13), adjusted for the same variables.Conclusion TNFi treatment was associated with a time-shifted effect on radiographic spinal progression in axSpA that became evident between years 2 and 4 after treatment initiation.Data are available upon reasonable request. The original study data can be made available upon reasonable request that should be directed to the corresponding author. ER -