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Two central readers scored the radiographs according to the modified New York criteria for ankylosing spondylitis. The sacroiliac sum score was calculated as a mean of the scores determined by both readers. TNFi use was assessed according to exposure in the current and\/or previous 2\u2010year radiographic interval. The association between TNFi use and radiographic sacroiliitis progression was examined by longitudinal generalized estimating equation analysis with adjustment for potential confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this long\u2010term inception cohort, 10\u2010year follow\u2010up data on 737 radiographic intervals assessed in 301 patients with axial SpA (166 patients with nonradiographic axial SpA and 135 patients with radiographic axial SpA) were obtained. Having received \u226512 months of treatment with TNFi in the previous 2\u2010year radiographic interval was associated with a significant decrease in the sacroiliitis sum score (\u03b2\u00a0=\u00a0\u20130.09 [95% confidence interval (95% CI) \u20130.18, \u20130.003]; analyses adjusted for age, sex, symptom duration, HLA\u2013B27 status, Bath Ankylosing Spondylitis Disease Activity Index score, C\u2010reactive protein, and nonsteroidal antiinflammatory drug intake). In contrast, among patients receiving TNFi in the current radiographic interval, there was no significant association with change in the sacroiliitis sum score (\u03b2\u00a0=\u00a00.05 [95% CI \u20130.05, 0.14]). This effect of having received \u226512 months of treatment with TNFi in the previous 2\u2010year radiographic interval was stronger in patients with nonradiographic axial SpA as compared to patients with radiographic axial SpA (\u03b2\u00a0=\u00a0\u20130.16 [95% CI \u20130.28, \u20130.03] versus \u03b2\u00a0=\u00a0\u20130.04 [95% CI \u20130.15, 0.07]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Treatment with TNFi was associated with the reduction in radiographic sacroiliitis progression in patients with axial SpA. This effect became evident between 2 and 4\u2009years after treatment was initiated.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.42144","type":"journal-article","created":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T01:49:09Z","timestamp":1650332949000},"page":"1515-1523","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Treatment With Tumor Necrosis Factor Inhibitors Is Associated With a <scp>Time\u2010Shifted<\/scp> Retardation of Radiographic Sacroiliitis Progression in Patients With Axial Spondyloarthritis: <scp>10\u2010Year<\/scp> Results From the German Spondyloarthritis Inception Cohort"],"prefix":"10.1002","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4600-9484","authenticated-orcid":false,"given":"Murat","family":"Torgutalp","sequence":"first","affiliation":[{"name":"Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Freie Universit\u00e4t Berlin, and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5612-043X","authenticated-orcid":false,"given":"Valeria","family":"Rios Rodriguez","sequence":"additional","affiliation":[{"name":"Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Freie Universit\u00e4t Berlin, and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4306-033X","authenticated-orcid":false,"given":"Fabian","family":"Proft","sequence":"additional","affiliation":[{"name":"Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Freie Universit\u00e4t Berlin, and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikhail","family":"Protopopov","sequence":"additional","affiliation":[{"name":"Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Freie Universit\u00e4t Berlin, and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryna","family":"Verba","sequence":"additional","affiliation":[{"name":"Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Freie Universit\u00e4t Berlin, and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7442-2570","authenticated-orcid":false,"given":"Judith","family":"Rademacher","sequence":"additional","affiliation":[{"name":"Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Freie Universit\u00e4t Berlin, and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hildrun","family":"Haibel","sequence":"additional","affiliation":[{"name":"Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Freie Universit\u00e4t Berlin, and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Sieper","sequence":"additional","affiliation":[{"name":"Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Freie Universit\u00e4t Berlin, and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Rudwaleit","sequence":"additional","affiliation":[{"name":"University of Bielefeld and Klinikum Bielefeld  Bielefeld Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4537-6015","authenticated-orcid":false,"given":"Denis","family":"Poddubnyy","sequence":"additional","affiliation":[{"name":"Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Freie Universit\u00e4t Berlin, Humboldt\u2010Universit\u00e4t zu Berlin, and German Rheumatism Research Center  Berlin 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