Evidence map›Paper›PMID 34857002›Full record

ArticlePediatric rheumatology online journal2021

Changes over time in inflammatory and structural lesions at the sacroiliac joint in children with spondyloarthritis exposed and unexposed to tumor necrosis factor inhibitor.

Timothy G Brandon, Rui Xiao, Rosemary G Peterson, Nancy A Chauvin, Michael L Francavilla, David M Biko, Dax G Rumsey, Matthew L Stoll, Pamela F Weiss

Open access · goldAbstract readMulticenter Study
In one paragraph

Article in Pediatric rheumatology online journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 37% 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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 2 countries.

Timothy G BrandonDivision of Rheumatology and Center for Pediatric Clinical Effectiveness at the Children's Hospital of Philadelphia, Department of Pediatrics, Philadelphia, USA.
Rui XiaoDepartment of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
Rosemary G PetersonDivision of Rheumatology at the Children's Hospital of Philadelphia, Department of Pediatrics, Philadelphia, USA.
Nancy A ChauvinDepartment of Radiology at Penn State Health Milton S. Hershey Children's Hospital, Hershey, PA, USA.
Michael L FrancavillaDepartment of Radiology at the Children's Hospital of Philadelphia and Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA.
David M BikoDepartment of Radiology at the Children's Hospital of Philadelphia and Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA.
Dax G RumseyDivision of Pediatric Rheumatology, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
Matthew L StollDivision of Pediatric Rheumatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
Pamela F WeissDepartment of Pediatrics, Division of Rheumatology and Center for Pediatric Clinical Effectiveness at the Children's Hospital of Philadelphia and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, 2716 South Street, Room 11121, Philadelphia, PA, 19104, USA. weisspa@chop.edu.ORCID http://orcid.org/0000-0002-9724-0443
Children's Hospital of Philadelphia · USPenn State Milton S. Hershey Medical Center · USUniversity of Alabama at Birmingham · USUniversity of Alberta · CAUniversity of Pennsylvania · US

Funding

Rheumatology Research Foundation Innovative Research Award
6 · The paper itself

Abstract

backgroundThe objective of this work was to describe magnetic resonance imaging (MRI) changes over time in inflammatory and structural lesions at the sacroiliac joint (SIJ) in children with spondyloarthritis (SpA) exposed and unexposed to tumor necrosis factor inhibitor (TNFi).

methodsThis was a retrospective, multicenter study of SpA patients with suspected or confirmed sacroiliitis who underwent at ≥2 pelvic MRI scans. Images were reviewed independently by 3 radiologists and scored for inflammatory and structural changes using the Spondyloarthritis Research Consortium of Canada (SPARCC) SIJ inflammation score (SIS) and structural score (SSS). Longitudinal, quantitative changes in patient MRI scans were measured using descriptive statistics and stratified by TNFi exposure. We used an average treatment effects (ATE) regression model to explore the average effect of TNFi exposure over time on inflammatory and structural lesions, adjusting for baseline lesion scores.

resultsForty-six subjects were evaluated using the SIS (n = 45) and SSS (n = 18). Median age at baseline imaging was 13.6 years, 63% were male and 71% were white. Twenty-three subjects (50%) were TNFi exposed between MRI studies. The median change in SIS in TNFi exposed and unexposed subjects with a baseline SIS ≥0 was - 20.7 and - 14.3, respectively (p = 0.09). Eleven (85%) TNFi exposed and 8 (89%) unexposed subjects with a baseline SIS ≥0 met the SIS minimal clinically important difference (MCID; ≥2.5). Using the ATE model adjusted for baseline SIS, the average effect of TNFi on SIS in patients with a baseline SIS ≥2 was - 14.5 (p < 0.01). Unadjusted erosion change score was significantly worse in TNFi unexposed versus exposed subjects (p = 0.03) but in the ATE model the effect of TNFi was not significant.

conclusionThis study quantitatively describes how lesions in the SIJs on MRI change over time in patients exposed to TNFi versus unexposed. Follow-up imaging in TNFi exposed patients showed greater improvement than the unexposed group by most metrics, some of which reached statistical significance. Surprisingly, a majority of TNFi unexposed children with a baseline SIS≥2 met the SIS MCID. Additional studies assessing the short and long-term effects of TNFi on inflammatory and structural changes in juvenile SpA are needed.

Indexed as

AdolescentChildFemaleHumansInflammationMagnetic Resonance ImagingMaleRetrospective StudiesSacroiliac JointSpondylarthritisTumor Necrosis Factor InhibitorsTumor Necrosis Factor InhibitorsDISEASE PROGRESSIONMAGNETIC RESONANCE IMAGINGPEDIATRICSSACROILIAC JOINTSPONDYOLARTHRITISTUMOR NECROSIS FACTOR INHIBITORS

Identifiers

PMID34857002
PMCPMC8638346
OpenAlexW3217735303

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.