title: Evaluation of treatments for sacroiliitis in spondyloarthropathy using the Spondyloarthritis Research Consortium Canada scoring system.
abstract: BACKGROUND
  In this study, the Spondyloarthritis Research Consortium Canada (SPARCC) scoring method was used to compare treatment methods in patients with axial spondyloarthritis (SpA), a form of sacroiliitis. MRI abnormalities in bone marrow edema (BME) were compared before and after treatment in order to compare the efficacy of anti-TNF-α and DMARD, alone or in combination, as treatments for sacroiliitis.
  
  
  METHODS
  Fifty-six Chinese patients with axial SpA (mean age 22.6 years) were recruited. Patients were divided into three groups according to different treatments (anti-TNF-α alone vs. DMARDs alone vs. combined anti-TNF-α and DMARDs). MRI examinations were performed before and after treatment. The SPARCC score, clinically relevant AS Disease Activity (ASDAS) indices, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were analyzed.
  
  
  RESULTS
  After treatment, ASDAS and SPARCC scores, ESR, and CRP were significantly improved (P < 0.05) in the anti-TNF-α monotherapy and combination groups; however, there were no statistically significant differences (P > 0.05) in clinical disease activity and radiological inflammation of sacroiliac joint (SIJ) in patients in the DMARDs alone group. SPARCC showed a correlation with ASDAS score pre-treatment, but not post-treatment. Furthermore, there were significant changes (P < 0.05) in these patients with axial SpA after only 3 months of treatment. Follow-up studies of patients who continued therapy for 4-6 months and 9-12 months revealed statistically significant differences from baseline (P < 0.05).
  
  
  CONCLUSIONS
  SPARCC can be used to assess severity of disease pre-treatment. Anti-TNF-α treatment resulted in effective reduction of disease activity and BME of SIJ after 3 months of therapy.
authors.affiliation: Department of Rheumatism, Guangdong General Hospital, No. 106, Zhongshaner Road, Guangzhou, China. cuiyang2003@medmail.com.cn.
authors.forename: Yang
authors.initials: Y
authors.lastname: Cui
authors.affiliation: Department of Rheumatism, Guangdong General Hospital, No. 106, Zhongshaner Road, Guangzhou, China. 404183856@qq.com.
authors.forename: Jinping
authors.initials: J
authors.lastname: Zheng
authors.affiliation: Department of Rheumatism, Guangdong General Hospital, No. 106, Zhongshaner Road, Guangzhou, China. xiaozhang640@sohu.com.
authors.forename: Xiao
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Medical Imaging Centre, Guangdong General Hospital, Guangzhou, 510010, China. 18898468865@139.com.
authors.forename: Hui
authors.initials: H
authors.lastname: Zeng
authors.affiliation: Department of Rheumatism, Guangdong General Hospital, No. 106, Zhongshaner Road, Guangzhou, China. luorq@tom.com.
authors.forename: Riqiang
authors.initials: R
authors.lastname: Luo
mesh_terms: D000293:Adolescent; D000328:Adult; D018501:Antirheumatic Agents / Q000494:pharmacology / Q000627:therapeutic use; D002170:Canada; D005260:Female; D006801:Humans; D008297:Male; D058566:Sacroiliitis / Q000175:diagnosis* / Q000188:drug therapy*; D012720:Severity of Illness Index; D025241:Spondylarthritis / Q000175:diagnosis* / Q000188:drug therapy*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha
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