{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T17:16:54Z","timestamp":1791911814905,"version":"4.3.4"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,11,12]],"date-time":"2018-11-12T00:00:00Z","timestamp":1541980800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Korea Health Technology R & D Project"},{"name":"Ministry of Health Welfare, Republic of Korea","award":["HI14C1277"],"award-info":[{"award-number":["HI14C1277"]}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis & Rheumatology"],"published-print":{"date-parts":[[2019,1]]},"abstract":"Objective<\/jats:title>To investigate the impact of tumor necrosis factor inhibitor (TNF<\/jats:styled-content>i) treatment and inflammation control on radiographic progression in early ankylosing spondylitis (AS<\/jats:styled-content>) over 4 years.<\/jats:p><\/jats:sec>Methods<\/jats:title>We included a total of 215 patients with early AS<\/jats:styled-content> (symptom duration <10 years) treated with TNF<\/jats:styled-content>i (the TNF<\/jats:styled-content>i group; n = 135) or with nonsteroidal antiinflammatory drugs (NSAID<\/jats:styled-content>s) (the control group; n = 80). Two blinded readers assessed radiographic progression using the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS<\/jats:styled-content>). Inflammation control was inferred from C\u2010reactive protein (CRP<\/jats:styled-content>) levels time\u2010averaged between 2 radiologic assessments. Linear mixed modeling was used to estimate mSASSS<\/jats:styled-content> changes over radiographic intervals as well as the impact of clinical factors on outcomes.<\/jats:p><\/jats:sec>Results<\/jats:title>The TNF<\/jats:styled-content>i group had longer disease duration, a higher baseline CRP<\/jats:styled-content> level, and a higher Bath Ankylosing Spondylitis Disease Activity Index than did controls. The time\u2010averaged CRP<\/jats:styled-content> level over radiographic intervals was lower with TNF<\/jats:styled-content>i treatment than with NSAID<\/jats:styled-content> treatment (mean \u00b1 SD<\/jats:styled-content> 0.27 \u00b1 0.30 mg\/dl versus 0.61 \u00b1 0.68 mg\/dl; P<\/jats:italic> < 0.001). Overall, mean \u00b1 SD mSASSS<\/jats:styled-content> change over the 2\u2010year interval was 1.30 \u00b1 2.97 units. In the multivariable model adjusted for age, smoking status, baseline CRP<\/jats:styled-content> level, and the presence of syndesmophytes at baseline, the TNF<\/jats:styled-content>i group showed less mSASSS<\/jats:styled-content> change over the 2\u2010year interval (\u03b2 = \u22120.90 [95% confidence interval {95% CI<\/jats:styled-content>} \u22121.51, \u22120.29]). However, when a time\u2010averaged CRP<\/jats:styled-content> level was additionally included, it significantly influenced the mSASSS<\/jats:styled-content> change (\u03b2 = 1.02 [95% CI<\/jats:styled-content> 0.32, 1.71]), decreasing the estimated group difference (\u03b2 = \u22120.52 [95% CI<\/jats:styled-content> \u22121.17, 0.14]). NSAID<\/jats:styled-content> indices of both groups were not associated with either time\u2010averaged CRP<\/jats:styled-content> levels or mSASSS<\/jats:styled-content> changes.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Effective suppression of inflammation by TNF<\/jats:styled-content>i treatment decreases radiographic progression in early AS<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.40661","type":"journal-article","created":{"date-parts":[[2018,7,9]],"date-time":"2018-07-09T02:30:21Z","timestamp":1531103421000},"page":"82-90","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Impact of Tumor Necrosis Factor Inhibitor Versus Nonsteroidal Antiinflammatory Drug Treatment on Radiographic Progression in Early Ankylosing Spondylitis: Its Relationship to Inflammation Control During Treatment"],"prefix":"10.1002","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8624-2582","authenticated-orcid":false,"given":"Jun Won","family":"Park","sequence":"first","affiliation":[{"name":"Seoul National University College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min Jung","family":"Kim","sequence":"additional","affiliation":[{"name":"Seoul National University College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8261-7044","authenticated-orcid":false,"given":"Jeong Seok","family":"Lee","sequence":"additional","affiliation":[{"name":"Seoul National University College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"You\u2010Jung","family":"Ha","sequence":"additional","affiliation":[{"name":"Seoul National University Bundang Hospital Gyeonggi\u2010do Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Kyun","family":"Park","sequence":"additional","affiliation":[{"name":"Seoul National University College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun Ha","family":"Kang","sequence":"additional","affiliation":[{"name":"Seoul National University Bundang Hospital Gyeonggi\u2010do Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun Jong","family":"Lee","sequence":"additional","affiliation":[{"name":"Seoul National University Bundang Hospital Gyeonggi\u2010do Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeong Wook","family":"Song","sequence":"additional","affiliation":[{"name":"Seoul National University College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6975-8627","authenticated-orcid":false,"given":"Eun Young","family":"Lee","sequence":"additional","affiliation":[{"name":"Seoul National University College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,11,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.21790"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.23901"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.23471"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar2794"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.38070"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-202698"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23097"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-200859"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.39690"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780270401"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.24483"},{"key":"e_1_2_7_13_1","first-page":"2286","article-title":"A 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