PMID- 33310864
OWN - NLM
STAT- MEDLINE
DCOM- 20210831
LR  - 20210831
IS  - 2056-5933 (Electronic)
IS  - 2056-5933 (Linking)
VI  - 6
IP  - 3
DP  - 2020 Dec
TI  - No relationship between bone mineral density and syndesmophyte formation at the 
      same level in the lumbar spine of patients with radiographic axial 
      Spondyloarthritis.
LID - 10.1136/rmdopen-2020-001391 [doi]
LID - e001391
AB  - OBJECTIVE: To investigate if in radiographic axial Spondyloarthritis (r-axSpA) 
      low vertebral bone mineral density (BMD) is associated with development of new 
      syndesmophytes at the same vertebral level. METHODS: In a post-hoc analysis from 
      the ASSERT trial (infliximab vs placebo), dual-energy X-ray absorptiometry was 
      used to measure baseline BMD (g/cm(2)) of the lumbar spine L1 to L4. 
      Syndesmophyte formation was assessed in the same vertebrae on conventional 
      radiographs defined as an increase in modified Stoke Ankylosing Spondylitis Spine 
      Score from 0 or 1 to 2 or 3 after 2 years. Radiographs were scored by two 
      readers. Generalised estimating equations (GEE) adjusted for within-patient 
      correlation across multiple vertebrae, taking potential confounders into account. 
      RESULTS: We analysed 599 vertebrae in 165 r-axSpA patients (78% male, mean (SD) 
      age 38 (10) years, 67% with at least one syndesmophyte anywhere in the spine). In 
      total, 24 to 74 new syndesmophytes developed in 9 (5%) to 30 (18%) patients and 
      13 (2%) to 39 (7%) vertebrae, if either a syndesmophyte was seen by both or only 
      one of the readers (ie, specific and sensitive definitions) respectively. In 
      multivariable analyses, no association was found between baseline local vertebral 
      BMD and new syndesmophyte formation after 2 years: adjOR (95% CI): 0.56 (0.01, 
      44.45) (specific definition) and 0.26 (0.03, 2.63) (sensitive definition). 
      CONCLUSION: In patients with active and established r-axSpA, with an observed low 
      incidence of lumbar spine syndesmophyte formation over 2 years, no relationship 
      was found between baseline BMD and new radiographic syndesmophyte formation at 
      the same vertebra.
CI  - (c) Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Marques, Mary Lucy
AU  - Marques ML
AUID- ORCID: 0000-0002-3071-9425
AD  - Department of Rheumatology, Leids Universitair Medisch Centrum, Leiden, 
      Netherlands mary.lucy.marques@gmail.com.
AD  - Department of Rheumatology, Centro Hospitalar E Universitario De Coimbra EPE, 
      Coimbra, Portugal.
FAU - Ramiro, Sofia
AU  - Ramiro S
AD  - Department of Rheumatology, Leids Universitair Medisch Centrum, Leiden, 
      Netherlands.
AD  - Department of Rheumatology, Zuyderland Medical Centre Heerlen, Heerlen, 
      Netherlands.
FAU - Machado, Pedro M
AU  - Machado PM
AUID- ORCID: 0000-0002-8411-7972
AD  - Centre for Rheumatology and Department of Neuromuscular Diseases, University 
      College London, London, UK.
AD  - Department of Rheumatology, University College London Hospitals NHS Foundation 
      Trust, London, UK.
AD  - Department of Rheumatology, Northwick Park Hospital, London North West University 
      Healthcare NHS Trust, London, UK.
FAU - van der Heijde, Desiree
AU  - van der Heijde D
AUID- ORCID: 0000-0002-5781-158X
AD  - Department of Rheumatology, Leids Universitair Medisch Centrum, Leiden, 
      Netherlands.
FAU - van Gaalen, Floris A
AU  - van Gaalen FA
AUID- ORCID: 0000-0001-8448-7407
AD  - Department of Rheumatology, Leids Universitair Medisch Centrum, Leiden, 
      Netherlands.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - RMD Open
JT  - RMD open
JID - 101662038
SB  - IM
MH  - Absorptiometry, Photon
MH  - Adult
MH  - Bone Density
MH  - Female
MH  - Humans
MH  - Lumbar Vertebrae/diagnostic imaging
MH  - Male
MH  - *Spondylarthritis/diagnostic imaging
MH  - *Spondylitis, Ankylosing/diagnostic imaging
PMC - PMC7856152
OTO - NOTNLM
OT  - Ankylosing
OT  - Bone Density
OT  - Inflammation
OT  - Spondylitis
COIS- Competing interests: None declared.
EDAT- 2020/12/15 06:00
MHDA- 2021/09/01 06:00
PMCR- 2020/12/08
CRDT- 2020/12/14 10:43
PHST- 2020/07/07 00:00 [received]
PHST- 2020/10/21 00:00 [revised]
PHST- 2020/11/13 00:00 [accepted]
PHST- 2020/12/14 10:43 [entrez]
PHST- 2020/12/15 06:00 [pubmed]
PHST- 2021/09/01 06:00 [medline]
PHST- 2020/12/08 00:00 [pmc-release]
AID - rmdopen-2020-001391 [pii]
AID - 10.1136/rmdopen-2020-001391 [doi]
PST - ppublish
SO  - RMD Open. 2020 Dec;6(3):e001391. doi: 10.1136/rmdopen-2020-001391.