Murat Torgutalp and colleagues investigated the longitudinal association between radiographic sacroiliitis progression and treatment with TNFi in patients with early axSpA in a long-term inception cohort. The results were shared in an oral session at the 2021 EULAR congress.
Based on the availability of at least two sets of sacroiliac joint (SIJ radiographs), 166 people with non-radiographic axialspondyloarthritis (nr-axSpA), and135 with radiographic (r-axSpA), from the German Spondyloarthritis Inception Cohort (GESPIC) were included in the analysis. Two trained and calibrated central readers scored the radiographs, and if both scored an image as definite radiographic sacroiliitis, the patient was classified as having r-axSpA. The association between previous and current TNFiuse, and change in the sacroiliitis sum score over 2 years was analysed.
At baseline, 9 (3.0%) patients were treated with a TNFi, and 87 (28.9%) patients received at least one TNFiduring the entire follow-up period. While receiving 12or more months of TNFi in the previous interval was associated with lower progression of the sacroiliitis sum score compared to not receiving TNFi in the previous interval, this was not the case in patients who received TNFi for longer than12 months in the current 2-year interval. The significant association between TNFi use for longer than12 months in the previous interval and progression in the sacroiliitis sum score were confirmed in the adjusted analysis. In addition, a similar trend for the beneficial effects was observed in different models, which included other treatment definitions with TNFi in the previous 2-year interval.
The authors concluded that TNFi treatment was associated with slowing radiographic sacroiliitis progression in people with axSpA. This effect became evident 2-4 years after treatment initiation.