FRI0216 Detection of structural lesions on t1 weighted mri versus radiography of the si joints in early axial spondyloarthritis: 2-year data
Authors: W.P. Maksymowych, P. Claudepierre, M. de Hooge, R.G. Lambert, R. Landewé, A. Molto, D. van der Heijde, J.F. Bukowski, H. Jones, I. Logeart, L. Marshall, R. Pedersen, A. Szumski, B. Vlahos, M. Dougados
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Sacroiliac joint (SIJ) structural damage may be evaluated using MRI, CT scan or radiographs. <h3>Objectives</h3> A post-hoc analysis of SIJ images from EMBARK (NCT01258738) and DESIR (NCT01648907) evaluated:<sup><sup>1</sup></sup> association between presence/absence of erosion on MRI and presence/absence of erosion or sacroiliitis on radiographs at BL and Wk 104;<sup><sup>2</sup></sup> association between decrease/increase in erosion score on MRI and decrease/increase in erosion or sacroiliitis grade on radiographs, BL to Wk 104. <h3>Methods</h3> All patients had early axSpA. EMBARK: 12 wks double-blind placebo-control, then 92 wks open-label etanercept. DESIR: patients had no history of biologics and received no biologics for 104 wks. MRI images from both studies: combined, anonymized, and read per patient; radiographs combined, anonymized, read separately from MRI. Readers unaware of: image chronology, original cohort. Three experienced readers individually reviewed T1 weighted MRI using SpondyloArthritis Research Consortium of Canada SIJ Structural Score; 3 different readers assessed radiographic sacroiliitis using mNY grade; all were at level of each joint surface. Lesion presence/absence or decrease/increase recorded per patient if ≥2 of 3 readers agreed. Statistical analyses: κ coefficient of agreement, McNemar's test for discordance asymmetry. <h3>Results</h3> 224 patients had MRI and radiographs. At BL, concordance for presence or absence of erosion in 162/224 (72.3%) (κ=0.42), table 1. Discordance: erosion more frequent on MRI (21.4%) than radiographs (6.3%; p&lt;0.0001). Wk 104 data similar to BL. Decrease in erosion more frequent than increase only on MRI; significantly more frequent on MRI than radiographs. Decrease in erosion on MRI significantly more frequent than decrease in sacroiliitis grade. <h3>Conclusions</h3> Findings of SIJ structural damage are observed differently on radiography and MRI in patients with early axSpA, and may appear to evolve differently. <h3>Disclosure of Interest</h3> W. Maksymowych Grant/research support from: AbbVie, Pfizer, Consultant for: Abbvie, Janssen, Lilly, Merck, Novartis, Pfizer, UCB, P. Claudepierre Consultant for: Abbvie, BMS, Celgene, Janssen, Novartis, Merck, Pfizer, Roche, UCB, Lilly, M. de Hooge Employee of: Selfemployed without other personnel (registered company under the Belgium law) MdH Research. Additional Affiliation: Ghent University, Ghent, Belgium, R. Lambert Consultant for: AbbVie, Bioclinica, Janssen, Parexel, UCB, R. Landewé Grant/research support from: Abbott, Amgen, Centocor, Novartis, Pfizer, Roche, Schering-Plough, UCB, Consultant for: AbbVie, Ablynx, Amgen, Astra-Zeneca, Bristol Myers Squibb, Celgene, Janssen, Galapagos, GlaxoSmithKline, Novartis, Novo-Nordisk, Merck, Pfizer, Roche, Schering-Plough, TiGenix, UCB, Employee of: Director of Rheumatology Consultancy BV, which is a registered company under Dutch law, Speakers bureau: Abbott/AbbVie, Amgen, Bristol Myers Squibb, Janssen, Merck, Pfizer, Roche, Schering-Plough, UCB, A. Molto Grant/research support from: Pfizer, Consultant for: Merck, UCB, D. van der Heijde Consultant for: AbbVie, Amgen, Astellas, AstraZeneca, BMS, Boehringer Ingelheim, Celgene, Daiichi, Lilly, Galapagos, Gilead, GlaxoSmithKline, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi, Takeda, UCB, Employee of: Director of Imaging Rheumatology bv, J. Bukowski Shareholder of: Pfizer, Employee of: Pfizer, H. Jones Shareholder of: Pfizer, Employee of: Pfizer, I. Logeart Shareholder of: Pfizer, Employee of: Pfizer, L. Marshall Shareholder of: Pfizer, Employee of: Pfizer, R. Pedersen Shareholder of: Pfizer, Employee of: Pfizer, A. Szumski Employee of: InVentiv Health, B. Vlahos Shareholder of: Pfizer, Employee of: Pfizer, M. Dougados Grant/research support from: Pfizer, AbbVie, UCB, Merck and Lilly, Consultant for: Pfizer, AbbVie, UCB, Merck and Lilly