{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T17:53:13Z","timestamp":1770141193175,"version":"3.49.0"},"reference-count":27,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,6,22]],"date-time":"2022-06-22T00:00:00Z","timestamp":1655856000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ACR Open Rheumatology"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Tumor necrosis factor inhibitors (TNFi) are an effective treatment for non\u2010radiographic axial spondyloarthritis (nr\u2010axSpA). To be eligible, however, many authorities require patients with nr\u2010axSpA to show active sacroiliitis on magnetic resonance imaging (MRI) and\/or an elevated C\u2010reactive protein (CRP) level, possibly resulting in a perception that patients with nr\u2010axSpA without both factors have only low responses to TNFi treatment. We evaluated clinical responses to certolizumab pegol (CZP) in patients with nr\u2010axSpA stratified by baseline MRI\/CRP status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>C\u2010axSpAnd was a phase 3, multicenter study on CZP in adult patients with active nr\u2010axSpA and objective signs of inflammation. This analysis assessed efficacy of CZP over the 52\u2010week randomized, double\u2010blind, placebo\u2010controlled period in patients stratified into subgroups based on the presence of active sacroiliitis on MRI and CRP level at baseline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>CZP\u2010treated patients across all MRI\/CRP subgroups achieved clinical responses greater than placebo. Across outcome measures, CZP\u2010treated MRI+\/CRP+ patients demonstrated the greatest clinical responses, but substantial improvements were also observed in CZP\u2010treated MRI+\/CRP\u2212 and MRI\u2212\/CRP+ patients. Ankylosing Spondylitis Disease Activity Score Major Improvement response rates at week 52 among CZP\u2010treated patients (75.6% MRI+\/CRP+; 47.5% MRI\u2212\/CRP+; and 29.7% MRI+\/CRP\u2212) were higher than rates in placebo groups (range: 3.9%\u201012.5%). Assessment of SpondyloArthritis international Society 40% response, Bath Ankylosing Spondylitis Disease Activity Index, and Bath Ankylosing Spondyloarthritis Functional Index had similar response patterns, although differences between the CZP\u2010treated MRI\/CRP subgroups were smaller. Clinical responses among CZP\u2010treated patients were also observed in additional subgroups, including those with low Spondyloarthritis Research Consortium of Canada MRI sacroiliac joint inflammation scores and those with normal baseline CRP levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings indicate that CZP treatment benefits patients with nr\u2010axSpA across MRI+\/CRP+, MRI\u2212\/CRP+, and MRI+\/CRP\u2212 subgroups.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr2.11469","type":"journal-article","created":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T01:51:06Z","timestamp":1655949066000},"page":"794-801","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Certolizumab Pegol Efficacy in Patients With <scp>Non\u2010Radiographic<\/scp> Axial Spondyloarthritis Stratified by Baseline <scp>MRI<\/scp> and <scp>C\u2010Reactive<\/scp> Protein Status: An Analysis From the <scp>C\u2010axSpAnd<\/scp> Study"],"prefix":"10.1002","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3156-3418","authenticated-orcid":false,"given":"Philip C.","family":"Robinson","sequence":"first","affiliation":[{"name":"University of Queensland School of Clinical Medicine  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1291-1755","authenticated-orcid":false,"given":"Walter P.","family":"Maksymowych","sequence":"additional","affiliation":[{"name":"University of Alberta  Edmonton Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6314-5336","authenticated-orcid":false,"given":"Lianne S.","family":"Gensler","sequence":"additional","affiliation":[{"name":"University of California San Francisco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Hall","sequence":"additional","affiliation":[{"name":"Monash University and Emeritus Research  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Rudwaleit","sequence":"additional","affiliation":[{"name":"University of Bielefeld  Bielefeld Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bengt","family":"Hoepken","sequence":"additional","affiliation":[{"name":"UCB Pharma, Monheim am Rhein  Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars","family":"Bauer","sequence":"additional","affiliation":[{"name":"UCB Pharma, Monheim am Rhein  Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Kumke","sequence":"additional","affiliation":[{"name":"UCB Pharma, Monheim am Rhein  Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mindy","family":"Kim","sequence":"additional","affiliation":[{"name":"UCB Pharma  Raleigh North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha","family":"de Peyrecave","sequence":"additional","affiliation":[{"name":"UCB Pharma  Brussels Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2130-1246","authenticated-orcid":false,"given":"Atul","family":"Deodhar","sequence":"additional","affiliation":[{"name":"Oregon Health &amp; Science University  Portland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,6,22]]},"reference":[{"issue":"2","key":"e_1_2_8_2_1","article-title":"The Assessment of SpondyloArthritis international Society (ASAS) handbook: a guide to assess spondyloarthritis","volume":"68","author":"Sieper J","year":"2009","journal-title":"Ann Rheum Dis"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2015-000053"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.24483"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21688"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-208642"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar3369"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-201766"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.39257"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2019-000917"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-211313"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.073098"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.145995"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-211596"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/1744666X.2018.1477591"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.40866"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kex174"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.21445"},{"issue":"10","key":"e_1_2_8_19_1","article-title":"Secukinumab improved signs and symptoms in patients with non\u2010radiographic axial spondyloarthritis: results from a randomized controlled phase III study stratified by baseline objective signs of inflammation [abstract]","volume":"72","author":"Braun J","year":"2020","journal-title":"Arthritis Rheumatol"},{"issue":"10","key":"e_1_2_8_20_1","article-title":"Efficacy of ixekizumab on disease activity and quality of life in patients with active nonradiographic axial spondyloarthritis and objective signs of inflammation, stratified by baseline CRP\/sacroiliac joint MRI status [abstract]","volume":"72","author":"Maksymowych WP","year":"2020","journal-title":"Arthritis Rheumatol"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.094870"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20575"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.38721"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.38921"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-018-1707-8"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2017-000586"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-019-0309-4"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-020-00552-4"}],"container-title":["ACR Open Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr2.11469","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/acr2.11469","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr2.11469","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T14:34:57Z","timestamp":1759415697000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr2.11469"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,22]]},"references-count":27,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2022,9]]}},"alternative-id":["10.1002\/acr2.11469"],"URL":"https:\/\/doi.org\/10.1002\/acr2.11469","archive":["Portico"],"relation":{},"ISSN":["2578-5745","2578-5745"],"issn-type":[{"value":"2578-5745","type":"print"},{"value":"2578-5745","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,22]]},"assertion":[{"value":"2021-12-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-05-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}