{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T23:06:03Z","timestamp":1787785563672,"version":"build-2784847793"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2019,1,28]],"date-time":"2019-01-28T00:00:00Z","timestamp":1548633600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2019,3,25]],"date-time":"2019-03-25T00:00:00Z","timestamp":1553472000000},"content-version":"vor","delay-in-days":56,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["asbmr.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,6,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>\u2003<\/jats:title>\n                  <jats:p>The aim of this cohort study was to evaluate the long-term effects of TNF inhibitors (TNFis) on BMD and the incidence of vertebral fractures (VFxs) in patients with ankylosing spondylitis (AS). Consecutive patients with active AS with TNFi treatment duration up to 4 years with available DXA scans and spine X-rays were included. BMD (classified according to the WHO criteria for osteoporosis) of the hip and lumbar spine, the VFx (classified as a Genant score text-decoration:underline1\/text-decoration:underline20% height loss), and radiological progression (modified stoke ankylosing spondylitis spinal score [mSASSS]) scores were obtained at baseline and at 4 years of TNFi treatment. Overall, 135 AS patients were included. At baseline, 40.1% of patients had low BMD of the hip and 40.2% of the lumbar spine. This decreased to 38.1% (p\u2009=\u20090.03) with low hip BMD and 25.3% (p\u2009&amp;lt;\u20090.001) of the lumbar spine BMD after 4 years of TNFi treatment. VFxs were present at baseline in 11.1% of the 131 patients, which increased to 19.6% after 4 years of TNFi treatment. A Genant score \u22652, was found at baseline in 3 out of 14 VFx (21.4%) patients, which increased to 7 out of 27 VFx (25.9%) patients after 4 years. All disease activity parameters\u2014the ankylosing spondylitis disease activity scale, the C-reactive protein, the erythrocyte sedimentation rate, and the bath ankylosing spondylitis disease activity index\u2014decreased significantly (p\u2009&amp;lt;\u20090.001). The mean radiological progression (n\u2009=\u200980) increased significantly from a median mSASSS of 4.0 (1.5 to 16.0) at baseline to 6.5 (2.1 to 22.9) after 4 years of TNFi treatment (p\u2009&amp;lt;\u20090.001). Despite the improvement in BMD and the decrease in disease activity, we still found new VFxs, an increase in severity in the number and grade of VFxs, and radiographic progression during 4 years of treatment with TNFis in AS patients with long disease duration. \u00a9 2019 American Society for Bone and Mineral Research.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/jbmr.3684","type":"journal-article","created":{"date-parts":[[2019,1,29]],"date-time":"2019-01-29T03:30:23Z","timestamp":1548732623000},"page":"1041-1048","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Long-Term Treatment With TNF-Alpha Inhibitors Improves Bone Mineral Density But Not Vertebral Fracture Progression in Ankylosing Spondylitis"],"prefix":"10.1093","volume":"34","author":[{"given":"Kimberley Johanna","family":"Beek","sequence":"first","affiliation":[{"name":"Department of Rheumatology Amsterdam Rheumatology and Immunology Centre Amsterdam UMC Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara","family":"Rusman","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Amsterdam Rheumatology and Immunology Centre Amsterdam UMC Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Alida Cornelia","family":"van der Weijden","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Groene hart ziekenhuis Gouda The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willem Frederik","family":"Lems","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Amsterdam Rheumatology and Immunology Centre, Reade Amsterdam The Netherlands"},{"name":"Department of Rheumatology Amsterdam Rheumatology and Immunology Centre Amsterdam UMC Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes Christiaan","family":"van Denderen","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Amsterdam Rheumatology and Immunology Centre, Reade Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Konsta","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Veterans Administration Hospital (NIMTS) Athens Greece"},{"name":"Department of Rheumatology Amsterdam Rheumatology and Immunology Centre Amsterdam UMC Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Visman","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Amsterdam Rheumatology and Immunology Centre Amsterdam UMC Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Twahier","family":"Nurmohamed","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Amsterdam Rheumatology and Immunology Centre, Reade Amsterdam The Netherlands"},{"name":"Department of Rheumatology Amsterdam Rheumatology and Immunology Centre Amsterdam UMC Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene Eva","family":"van der Horst-Bruinsma","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Amsterdam Rheumatology and Immunology Centre Amsterdam UMC Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,1,28]]},"reference":[{"key":"2024021014430497100_jbmr3684-bib-0001","first-page":"CD005468","article-title":"TNF-alpha inhibitors for ankylosing spondylitis","volume":"4","author":"Maxwell","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"issue":"6","key":"2024021014430497100_jbmr3684-bib-0002","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1136\/annrheumdis-2014-205322","article-title":"Efficacy of TNFalpha blockers in patients with ankylosing 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