{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T10:29:00Z","timestamp":1789122540529,"version":"build-2803163510"},"reference-count":18,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2024,9,3]],"date-time":"2024-09-03T00:00:00Z","timestamp":1725321600000},"content-version":"unspecified","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100015661","name":"UCB Pharma","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015661","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2024,7,22]]},"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>A consensus definition for active sacroiliitis by MRI, mentioned in the Assessment of SpondyloArthritis International Society (ASAS) classification criteria for axial spondyloarthritis (axSpA), was published in 2009 and included a qualitative and quantitative MRI cut-off component. In 2021, updates to the quantitative component were preliminarily proposed. This post hoc analysis of part A of the phase 3 open-label C-OPTIMISE study (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT02505542\">NCT02505542<\/jats:ext-link>) explores the differences by applying the 2009 and preliminary 2021 inflammatory cut-offs on clinical outcomes of axSpA patients treated with certolizumab pegol.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Baseline MRI scans were used to classify 657 patients as MRI+ or MRI\u2013 according to the quantitative components of the 2009 and preliminary 2021 MRI cut-offs for inflammatory lesions. Clinical outcomes, including ASAS \u226540% improvement (ASAS40), Ankylosing Spondylitis Disease Activity Score and Bath Ankylosing Spondylitis Disease Activity Index, were reported to week 48.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Across all analysed outcomes, 2009 MRI+ and preliminary 2021 MRI+ subgroups showed similar results. Notably, clinical outcomes for the discordant group (2009 MRI+but preliminary 2021 MRI\u2013 group; 53\/657 [8.1%]) were close to those seen in MRI\u2013 patients according to either 2009 or preliminary 2021 inflammatory cut-offs, and notably different from the totality of MRI+ subgroups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This analysis suggests that the preliminary 2021 cut-offs for MRI inflammatory lesions may slightly increase the specificity of the quantitative part of the 2009 MRI inflammatory lesion definition. The effects of the updated MRI cut-offs need to be assessed on the basis of efficacy outcomes and with the inclusion of aspects of structural changes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT02505542\">NCT02505542<\/jats:ext-link>.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2023-003886","type":"journal-article","created":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T00:45:23Z","timestamp":1725410723000},"page":"e003886","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Comparison of established and preliminarily proposed ASAS MRI working group cut-offs for inflammatory MRI lesions in the sacroiliac joints in radiographic and non-radiographic axial spondyloarthritis"],"prefix":"10.1136","volume":"10","clinical-trial-number":[{"clinical-trial-number":"nct02505542","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct02505542","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct02505542","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct02505542","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9475-9362","authenticated-orcid":false,"given":"Xenofon","family":"Baraliakos","sequence":"first","affiliation":[{"name":"Rheumazentrum Ruhrgebiet, Ruhr University Bochum, Herne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8411-7972","authenticated-orcid":false,"given":"Pedro M","family":"Machado","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, University College London Hospitals NHS Foundation Trust, London, UK"},{"name":"Department of Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK"},{"name":"Centre for Rheumatology & Department of Neuromuscular Diseases, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Bauer","sequence":"additional","affiliation":[{"name":"UCB Pharma, Monheim am Rhein, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bengt","family":"Hoepken","sequence":"additional","affiliation":[{"name":"UCB Pharma, Monheim am Rhein, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mindy","family":"Kim","sequence":"additional","affiliation":[{"name":"UCB Pharma, Smyrna, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Kumke","sequence":"additional","affiliation":[{"name":"UCB Pharma, Monheim am Rhein, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Tham","sequence":"additional","affiliation":[{"name":"UCB Pharma, Slough, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5445-548X","authenticated-orcid":false,"given":"Martin","family":"Rudwaleit","sequence":"additional","affiliation":[{"name":"Klinikum Bielefled, University of Bielefeld, Bielefeld, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,9,3]]},"reference":[{"key":"2025090313423157000_10.3.e003886.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31591-4"},{"key":"2025090313423157000_10.3.e003886.2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780270401"},{"key":"2025090313423157000_10.3.e003886.3","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1038\/s41584-020-00552-4","article-title":"Axial spondyloarthritis: concept, construct, classification and implications for therapy","volume":"17","author":"Robinson","year":"2021","journal-title":"Nat Rev Rheumatol"},{"key":"2025090313423157000_10.3.e003886.4","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1007\/s40744-020-00214-7","article-title":"Induction of Sustained Clinical Remission in Early Axial Spondyloarthritis Following Certolizumab Pegol Treatment: 48-Week Outcomes from C-OPTIMISE","volume":"7","author":"Landew\u00e9","year":"2020","journal-title":"Rheumatol Ther"},{"key":"2025090313423157000_10.3.e003886.5","unstructured":"Administration FaD . CIMZIA (certolizumab pegol). Product information: UCB, Inc., Smyrna, GA, USA. Available: https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2019\/125160s237lbl.Pdf [Accessed 16 Aug 2023]."},{"key":"2025090313423157000_10.3.e003886.6","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.110767"},{"key":"2025090313423157000_10.3.e003886.7","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-208642"},{"key":"2025090313423157000_10.3.e003886.8","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1002\/art.40429","article-title":"Frequency and Anatomic Distribution of Magnetic Resonance Imaging Features in the Sacroiliac Joints of Young Athletes: Exploring \u201cBackground Noise\u201d Toward a Data-Driven Definition of Sacroiliitis in Early Spondyloarthritis","volume":"70","author":"Weber","year":"2018","journal-title":"Arthritis Rheumatol"},{"key":"2025090313423157000_10.3.e003886.9","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-205408"},{"key":"2025090313423157000_10.3.e003886.10","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1093\/rheumatology\/kex491","article-title":"Effect of mechanical stress on magnetic resonance imaging of the sacroiliac joints: assessment of military recruits by magnetic resonance imaging study","volume":"57","author":"Varkas","year":"2018","journal-title":"Rheumatology (Oxford)"},{"key":"2025090313423157000_10.3.e003886.11","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1002\/art.40475","article-title":"Magnetic Resonance Imaging of the Sacroiliac Joints Indicating Sacroiliitis According to the Assessment of SpondyloArthritis international Society Definition in Healthy Individuals, Runners, and Women With Postpartum Back Pain","volume":"70","author":"de Winter","year":"2018","journal-title":"Arthritis Rheumatol"},{"key":"2025090313423157000_10.3.e003886.12","doi-asserted-by":"publisher","DOI":"10.1002\/art.27571"},{"key":"2025090313423157000_10.3.e003886.13","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2019-215553"},{"key":"2025090313423157000_10.3.e003886.14","doi-asserted-by":"crossref","first-page":"4778","DOI":"10.1093\/rheumatology\/keab099","article-title":"Data-driven definitions for active and structural MRI lesions in the sacroiliac joint in spondyloarthritis and their predictive utility","volume":"60","author":"Maksymowych","year":"2021","journal-title":"Rheumatology (Oxford)"},{"key":"2025090313423157000_10.3.e003886.15","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-eular.4182"},{"key":"2025090313423157000_10.3.e003886.16","doi-asserted-by":"crossref","first-page":"102703","DOI":"10.1016\/j.autrev.2020.102703","article-title":"Do we believe in non-radiographic axial spondyloarthritis? A debate","volume":"20","author":"Ortolan","year":"2021","journal-title":"Autoimmun Rev"},{"key":"2025090313423157000_10.3.e003886.17","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-201884"},{"key":"2025090313423157000_10.3.e003886.18","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-207823"}],"container-title":["RMD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rmdopen-2023-003886","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T20:42:39Z","timestamp":1756932159000},"score":1,"resource":{"primary":{"URL":"https:\/\/rmdopen.bmj.com\/lookup\/doi\/10.1136\/rmdopen-2023-003886"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9]]},"references-count":18,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,9,3]]},"published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1136\/rmdopen-2023-003886"],"URL":"https:\/\/doi.org\/10.1136\/rmdopen-2023-003886","relation":{},"ISSN":["2056-5933"],"issn-type":[{"value":"2056-5933","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9]]}}}