{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T10:28:03Z","timestamp":1789122483791,"version":"build-2803163510"},"reference-count":27,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T00:00:00Z","timestamp":1736121600000},"content-version":"unspecified","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2024,11,25]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>In this post-hoc analysis of ESTHER trial, we aimed to investigate the longitudinal relationship between inflammation on MRI and the achievement of inactive disease\/low disease activity in patients with axial spondyloarthritis (axSpA) treated with long-term tumor necrosis factor (TNF) inhibitor etanercept.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Of the 76 patients with active axSpA in the ESTHER trial, we included all patients treated with etanercept for at least 6 months for main analysis. All clinical and MRI data from 4.5 years of follow-up were used in the analysis. MRIs of the spine and sacroiliac (SI) joints were performed at baseline, week 24, week 48 and yearly thereafter and were evaluated for active inflammatory lesions according to the Berlin MRI score.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Longitudinal analysis showed that higher SI joint osteitis score was associated with higher Axial Spondyloarthritis Disease Activity Score (ASDAS) at the same time point (\u03b2=0.08, 95% CI (0.05; 0.11)) and at the next time point 6 months later (\u03b2=0.05, 95% CI (0.02; 0.07)). Furthermore, resolution of osteitis in the SI joint (Berlin MRI osteitis score of \u22641) was associated with lower ASDAS at the next time point (\u03b2=\u22120.26, 95% CI (\u22120.42; \u22120.09)), higher odds of achieving ASDAS low disease activity (OR=5.61, 95% CI (1.06; 29.67)) and inactive disease status (OR=2.23, 95% CI (1.01; 4.94)) at the next time point.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The presence of inflammation on SI joints-MRI is associated with higher disease activity in axSpA. Resolution of inflammation on MRI is associated with better clinical outcomes in the long-term follow-up. Thus, achieving complete resolution of inflammation is favourable for meeting the treatment goals in axSpA.<\/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=\"NCT00844142\">NCT00844142<\/jats:ext-link>.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2024-004921","type":"journal-article","created":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T21:05:52Z","timestamp":1736197552000},"page":"e004921","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Association between resolution of MRI-detected inflammation and improved clinical outcomes in axial spondyloarthritis under long-term anti-TNF therapy"],"prefix":"10.1136","volume":"11","clinical-trial-number":[{"clinical-trial-number":"nct00844142","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct00844142","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4600-9484","authenticated-orcid":false,"given":"Murat","family":"Torgutalp","sequence":"first","affiliation":[{"name":"Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine), Charite Universitatsmedizin 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":"Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine), Charite Universitatsmedizin Berlin, Berlin, Germany"},{"name":"Berlin Institute of Health at Charite, 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":"Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine), Charite Universitatsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kay-Geert","family":"Hermann","sequence":"additional","affiliation":[{"name":"Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Department of Radiology (including Pediatric Radiology), Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Althoff","sequence":"additional","affiliation":[{"name":"HELIOS Klinikum Emil von Behring GmbH, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Haibel","sequence":"additional","affiliation":[{"name":"Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine), Charite Universitatsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4840-5069","authenticated-orcid":false,"given":"Mikhail","family":"Protopopov","sequence":"additional","affiliation":[{"name":"Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine), Charite Universitatsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0285-9890","authenticated-orcid":false,"given":"Joachim","family":"Sieper","sequence":"additional","affiliation":[{"name":"Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine), Charite Universitatsmedizin 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":"Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine), Charite Universitatsmedizin Berlin, Berlin, 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":"Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine), Charite Universitatsmedizin Berlin, Berlin, Germany"},{"name":"Epidemiology Unit, German Rheumatism Research Center Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,1,6]]},"reference":[{"key":"2025090312284272000_11.1.e004921.1","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2023-225185"},{"key":"2025090312284272000_11.1.e004921.2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780270401"},{"key":"2025090312284272000_11.1.e004921.3","doi-asserted-by":"crossref","first-page":"1550","DOI":"10.1136\/annrheumdis-2019-215589","article-title":"MRI lesions in the sacroiliac joints of patients with spondyloarthritis: an update of definitions and validation by the ASAS MRI working group","volume":"78","author":"Maksymowych","year":"2019","journal-title":"Ann Rheum 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in axial spondyloarthritis patients with NSAID\/anti-TNF-\u03b1 drug-induced clinical remission","volume":"41","author":"Zong","year":"2022","journal-title":"Clin Rheumatol"},{"key":"2025090312284272000_11.1.e004921.10","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2022-223296"},{"key":"2025090312284272000_11.1.e004921.11","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-211734"},{"key":"2025090312284272000_11.1.e004921.12","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.094870"},{"key":"2025090312284272000_11.1.e004921.13","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.139667"},{"key":"2025090312284272000_11.1.e004921.14","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-201545"},{"key":"2025090312284272000_11.1.e004921.15","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.147033"},{"key":"2025090312284272000_11.1.e004921.16","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-201010"},{"key":"2025090312284272000_11.1.e004921.17","doi-asserted-by":"crossref","unstructured":"Proft F , Wei\u00df A , Torgutalp M , et al . Sustained clinical response and safety of etanercept in patients with early axial spondyloarthritis: 10-year results of the ESTHER trial. Ther Adv Musculoskelet Dis 2021;13. doi:10.1177\/1759720X20987700","DOI":"10.1177\/1759720X20987700"},{"key":"2025090312284272000_11.1.e004921.18","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.138594"},{"key":"2025090312284272000_11.1.e004921.19","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-201766"},{"key":"2025090312284272000_11.1.e004921.20","doi-asserted-by":"crossref","first-page":"2702","DOI":"10.1002\/art.39257","article-title":"A randomized, double-blind, placebo-controlled, sixteen-week study of subcutaneous golimumab in patients with active nonradiographic axial spondyloarthritis","volume":"67","author":"Sieper","year":"2015","journal-title":"Arthritis Rheumatol"},{"key":"2025090312284272000_11.1.e004921.21","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1002\/art.39434","article-title":"Course of Magnetic Resonance Imaging-Detected Inflammation and Structural Lesions in the Sacroiliac Joints of Patients in the Randomized, Double-Blind, Placebo-Controlled Danish Multicenter Study of Adalimumab in Spondyloarthritis, as Assessed by the Berlin and Spondyloarthritis Research Consortium of Canada Methods","volume":"68","author":"Pedersen","year":"2016","journal-title":"Arthritis Rheumatol"},{"key":"2025090312284272000_11.1.e004921.22","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2017-000430","article-title":"Effect of certolizumab pegol over 96\u2005weeks of treatment on inflammation of the spine and sacroiliac joints, as measured by MRI, and the association between clinical and MRI outcomes in patients with axial spondyloarthritis","volume":"3","author":"Braun","year":"2017","journal-title":"RMD Open"},{"key":"2025090312284272000_11.1.e004921.23","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1002\/acr2.11581","article-title":"Effect of Biologics in Subgroups of Axial Spondyloarthritis Based on Magnetic Resonance Imaging and C-Reactive Protein: A Systematic Review and Meta-Analysis","volume":"5","author":"Karmacharya","year":"2023","journal-title":"ACR Open Rheumatol"},{"key":"2025090312284272000_11.1.e004921.24","doi-asserted-by":"crossref","first-page":"2397","DOI":"10.1007\/s10067-023-06658-w","article-title":"The correlations between C-reactive protein and MRI-detected inflammation in patients with axial spondyloarthritis: a systematic review and meta-analysis","volume":"42","author":"Tian","year":"2023","journal-title":"Clin Rheumatol"},{"key":"2025090312284272000_11.1.e004921.25","doi-asserted-by":"publisher","DOI":"10.1002\/art.21445"},{"key":"2025090312284272000_11.1.e004921.26","doi-asserted-by":"crossref","first-page":"ii1","DOI":"10.1136\/ard.2008.104018","article-title":"The Assessment of SpondyloArthritis international Society (ASAS) handbook: a guide to assess spondyloarthritis","volume":"68 Suppl 2","author":"Sieper","year":"2009","journal-title":"Ann Rheum Dis"},{"key":"2025090312284272000_11.1.e004921.27","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1002\/art.41042","article-title":"2019 Update of the American College of Rheumatology\/Spondylitis Association of America\/Spondyloarthritis Research and Treatment Network Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis","volume":"71","author":"Ward","year":"2019","journal-title":"Arthritis Rheumatol"}],"container-title":["RMD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rmdopen-2024-004921","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T19:28:51Z","timestamp":1756927731000},"score":1,"resource":{"primary":{"URL":"https:\/\/rmdopen.bmj.com\/lookup\/doi\/10.1136\/rmdopen-2024-004921"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,6]]},"published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1136\/rmdopen-2024-004921"],"URL":"https:\/\/doi.org\/10.1136\/rmdopen-2024-004921","relation":{},"ISSN":["2056-5933"],"issn-type":[{"value":"2056-5933","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}