Evidence map›Paper›PMID 36759008›Full record

ArticleRMD open2023

Inflammation, bone loss and 2-year bone formation at the same vertebra in axial spondyloarthritis: a multilevel MRI and low-dose CT analysis.

Mary Lucy Marques, Nuno Pereira da Silva, Desirée van der Heijde, Rosalinde Stal, Xenofon Baraliakos, Juergen Braun, Monique Reijnierse, Caroline Bastiaenen, Sofia Ramiro, Floris A van Gaalen

Open access · goldAbstract read
In one paragraph

Article in RMD open, 2023. 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
0.5field-weighted citation impact, top 35% 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

10 authors at 4 institutions in 3 countries.

Mary Lucy MarquesRheumatology department, Leiden University Medical Center, Leiden, Netherlands mary.lucy.marques@gmail.com.ORCID 0000-0002-3071-9425
Nuno Pereira da SilvaRadiology department, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal.
Desirée van der HeijdeRheumatology department, Leiden University Medical Center, Leiden, Netherlands.ORCID 0000-0002-5781-158X
Rosalinde StalRheumatology department, Leiden University Medical Center, Leiden, Netherlands.ORCID 0000-0002-6706-3933
Xenofon BaraliakosRheumazentrum Ruhrgebiet, Ruhr University Bochum, Herne, Germany.ORCID 0000-0002-9475-9362
Juergen BraunRheumazentrum Ruhrgebiet, Ruhr University Bochum, Herne, Germany.ORCID 0000-0002-9156-5095
Monique ReijnierseRadiology department, Leiden University Medical Center, Leiden, Netherlands.
Caroline BastiaenenEpidemiology department, Maastricht University, Maastricht, Netherlands.
Sofia RamiroRheumatology department, Leiden University Medical Center, Leiden, Netherlands.ORCID 0000-0002-8899-9087
Floris A van GaalenRheumatology department, Leiden University Medical Center, Leiden, Netherlands.ORCID 0000-0001-8448-7407
Leiden University Medical Center · NLRheumazentrum Ruhrgebiet · DEHospitais da Universidade de Coimbra · PTMaastricht University · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo investigate whether in radiographic axial spondyloarthritis (r-axSpA) inflammation is associated with lower trabecular bone density (TBD), and subsequently, if a lower TBD increases the likelihood of 2-year bone formation at the same vertebra.

methodsWhole spine (C3-L5) data from patients included in the multicentre 2-year Sensitive Imaging in Ankylosing Spondylitis cohort was used. Two readers measured baseline TBD by Hounsfield units (HU) on low-dose CT (ldCT). Baseline MRI bone marrow oedema (BME) status scores and ldCT syndesmophyte formation and/or growth change-from-baseline scores were assessed by three and two readers, respectively. Average of readers' continuous measurements or readers' agreement in binary scores generated within the same vertebra (1-present in ≥1 quadrant/0-absent in all quadrants) were used. Multilevel generalised estimating equations models were used, the unit of analysis being the vertebra.

resultsIn 50 patients with r-axSpA, TBD HU decreased from cranial to caudal vertebrae. Baseline MRI-BME was present in 300/985 (30%) and syndesmophytes in 588/910 (65%) vertebrae, both most prevalent at thoracolumbar region. Syndesmophyte formation or growth was observed in 18% of at-risk vertebrae (124/691). A significant confounder-adjusted association was found between inflammation and lower TBD (regression coefficient=-51; 95% CI-63 to -39). TBD was not associated with 2-year syndesmophyte formation or growth (adjusted OR 1.00; 95% CI 0.99 to 1.00).

conclusionIn r-axSpA, while vertebral inflammation was associated with lower vertebral TBD, lower vertebral TBD itself did not increase the risk for new bone formation at the same vertebra. In preventing syndesmophyte progression, targeting local inflammation seems more important than targeting vertebral trabecular bone loss.

Indexed as

OsteitisSpondylitis, AnkylosingDisease ProgressionHumansInflammationMagnetic Resonance ImagingOsteogenesisSpineTomography, X-Ray ComputedInflammationOutcome Assessment, Health CareSpondylitis, Ankylosing

Identifiers

PMID36759008
PMCPMC9923353
OpenAlexW4319731938

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.