Evidence map›Paper›PMID 21372193›Full record

Trial reportAnnals of the rheumatic diseases2011

Effects of etanercept versus sulfasalazine in early axial spondyloarthritis on active inflammatory lesions as detected by whole-body MRI (ESTHER): a 48-week randomised controlled trial.

I-H Song, Kg Hermann, H Haibel, C E Althoff, Ce Althoff, J Listing, Gr Burmester, A Krause, M Bohl-Bühler, B Freundlich and 2 more

Erratum issuedOpen access · bronzeAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Annals of the rheumatic diseases, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 98 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
98citing papers in PubMed, 12 pooled it
23.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

98 citing papers in PubMed, 12 syntheses or guidelines pooled it, 288 citations in OpenAlex.

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  10. Sulfasalazine for ankylosing spondylitis.The Cochrane database of systematic reviews · 2014
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38 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

  • Erratum issued
    Althoff, Ce [corrected to Althoff, C E]
5 · Who and what money

Authors and funding

12 authors at 3 institutions in 2 countries.

I-H SongCampus Benjamin Franklin, Med Clinic I, Rheumatology, Hindenburgdamm 30, 12200 Berlin, Germany.
Kg Hermann
H Haibel
C E Althoff
Ce Althoff
J Listing
Gr Burmester
A Krause
M Bohl-Bühler
B Freundlich
M Rudwaleit
J Sieper
Charité - Universitätsmedizin Berlin · DEGerman Rheumatism Research Centre · DEUniversity of Pennsylvania · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate the potential of etanercept versus sulfasalazine to reduce active inflammatory lesions on whole-body MRI in active axial spondyloarthritis with a symptom duration of less than 5 years.

methodsPatients were randomly assigned to etanercept (n=40) or sulfasalazine (n=36) treatment over 48 weeks. All patients showed active inflammatory lesions (bone marrow oedema) on MRI in either the sacroiliac joints or the spine. MRI was performed at weeks 0, 24 and 48 and was scored for active inflammatory lesions in sacroiliac joints and the spine including posterior segments and peripheral enthesitis by two radiologists, blinded for treatment arm and MRI time point.

resultsIn the etanercept group, the reduction of the sacroiliac joint score from 7.7 at baseline to 2.0 at week 48 was significantly (p=0.02) larger compared with the sulfasalazine group from 5.4 at baseline to 3.5 at week 48. A similar difference in the reduction of inflammation was found in the spine from 2.2 to 1.0 in the etanercept group versus from 1.4 to 1.3 in the sulfasalazine group between baseline and week 48, respectively (p=0.01). The number of enthesitic sites also improved significantly from 26 to 11 in the etanercept group versus 24 to 26 in the sulfasalazine group (p=0.04 for difference). 50% of patients reached clinical remission in the etanercept group versus 19% in the sulfasalazine group at week 48.

conclusionIn patients with early axial spondyloarthritis active inflammatory lesions detected by whole-body MRI improved significantly more in etanercept versus sulfasalazine-treated patients. This effect correlated with a good clinical response in the etanercept group.

Indexed as

AdolescentAdultAntirheumatic AgentsEpidemiologic MethodsEtanerceptFemaleHumansImmunoglobulin GMagnetic Resonance ImagingMaleMiddle AgedReceptors, Tumor Necrosis FactorSacroiliac JointSpineSpondylarthritisSulfasalazineAntirheumatic AgentsEtanerceptImmunoglobulin GReceptors, Tumor Necrosis FactorSulfasalazineTumor Necrosis Factor-alpha

Identifiers

PMID21372193
PMCPMC3211465
OpenAlexW2137068168

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.