FRI0158 Ankylosing Spondylitis Spinal Magnetic Resonance Imaging Activity Score is Associated with the Disease Activity of Ankylosing Spondylitis: A Systematic Literature Review with Meta-Analysis
Authors: Z. Huang, T. Li, W. Deng, S. Zheng, X. Guo, K. Qiu
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Magnetic resonance imaging (MRI) of the spine is increasingly employed to detect spinal inflammation in the patients with ankylosing spondylitis (AS). AS spinal MRI activity score (ASspiMRI-a) is a novel scoring system, which was described to be reliable for assessment and quantification of acute spinal lesions of AS patients. However, the relation between ASspiMRI-a and the disease activity of AS patients is still unclear. <h3>Objectives</h3> The aim of this study was to determine whether ASspiMRI-a is correlate with the disease activity of AS patients through a systemic literature review with meta-analysis. <h3>Methods</h3> A systematic literature review was conducted using electronic databases (Medline, EMBase, and the Cochrane Library). Studies were eligible if they reported the correlation coefficients between ASspiMRI-a and disease activity scores, including Bath AS disease activity score (BASDAI), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Two authors performed literature selection and data extraction independently, with disagreement resolved by consensus. In the meta-analysis of correlation coefficients, data were converted into Fisher9s z values. The pooled Fisher9s z values and their 95% confidence intervals (CIs) were then computed using Review Manager 5.0 software. After that, all these results were transformed back into correlation values (<i>r</i>). Heterogeneity was assessed using the I<sup>2</sup> statistic. <h3>Results</h3> Of 322 studies initially identified, 6 were appropriate for further meta-analysis, comprising 212 patients. Based on these studies, high heterogeneity was observed only in the meta-analysis of correlation coefficient between ASspiMRI-a on short tau inversion recovery image and BASDAI (I<sup>2</sup> =78%, <i>p</i>&lt;0.05), so it was performed using a random effects model (<i>p</i>&lt;0.05, <i>r</i>=0.90, 95% CI: 0.79∼0.97). For the other analysis, the pooled Fisher9s z values and their 95% CIs were computed using a fix effects model. Otherwise, ASspiMRI-a on contrast-enhanced T1-weighted images was significantly associated with BASDAI (<i>p</i>&lt;0.05, <i>r</i>=0.95, 95% CI: 0.91∼0.98). In addition, ASspiMRI-a correlated well with ESR (<i>p</i>&lt;0.05, <i>r</i>=0.87, 95% CI: 0.79∼0.93) and CRP (<i>p</i>&lt;0.05, <i>r</i>=0.88, 95% CI: 0.80∼0.94). <h3>Conclusions</h3> This systematic literature review and meta-analysis suggested ASspiMRI-a is associated with BASDAI, ESR and CRP of AS patients, so the spinal inflammation assessment by MRI might contribute to the determination of the disease activity of AS patients. <h3>References</h3> Goh L, Suresh P, Gafoor A, et al. Disease activity in longstanding ankylosing spondylitis: a correlation of clinical and magnetic resonance imaging findings. Clin Rheumatol. 2008, 27(4):449-55. Konca S, Keskin D, Cılız D, et al. Spinal inflammation by magnetic resonance imaging in patients with ankylosing spondylitis: association with disease activity and outcome parameters. Rheumatol Int. 2012, 32(12):3765-70. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.3449