title: Performance of 3 Enthesitis Indices in Patients with Peripheral Spondyloarthritis During Treatment with Adalimumab.
abstract: To evaluate the validity of enthesitis indices in patients with peripheral spondyloarthritis (pSpA).
  
  
  
  The ABILITY-2 study evaluated the efficacy of adalimumab (ADA) versus placebo (PBO) in patients with active pSpA over 12 weeks. Patients received open-label ADA for an additional 144 weeks. Twenty-nine enthesitis sites used in 3 enthesitis scoring systems [Leeds Enthesitis Index (LEI), Spondyloarthritis Research Consortium of Canada (SPARCC) Enthesitis Index, Maastricht Ankylosing Spondylitis Enthesitis Score (MASES)] were assessed; discriminatory capacity and treatment response at Week 12 were calculated by standardized mean difference (SMD) and Guyatt's effect size (ES). Sites showing resolution or new-onset enthesitis from baseline to Week 12 were analyzed.
  
  
  
  Overall, 165 patients (ADA, n = 84; PBO, n = 81) were randomized; 143 had ≥ 1 enthesitis site at baseline. The LEI (SMD -0.73, ES -1.07) and SPARCC (SMD -0.56, ES -0.99) enthesitis indices showed higher discriminatory ability and treatment response than MASES (SMD -0.32, ES -0.81). At Week 12, among sites that were positive at baseline, significantly more (p < 0.05) showed resolution among patients treated with ADA versus PBO in the Achilles tendon (60.4% and 36.5%, respectively), medial epicondyle (73.2%, 48.7%), lateral epicondyle (80.6%, 52.8%), and iliac crest (73.5%, 47.2%). Among negative sites at baseline, significantly less (p < 0.05) new-onset enthesitis was observed with ADA versus PBO for Achilles tendon (3.6% and 10.9%, respectively), greater trochanter (3.4%, 14.4%), lateral epicondyle humerus (4.7%, 15.1%), medial femoral condyle (1.6%, 9.2%), and quadriceps insertion superior patella (1.5%, 7.0%).
  
  
  
  The LEI and SPARCC enthesitis indices showed better discriminatory capacity and treatment response in patients with pSpA versus MASES, likely because these indices contain more peripheral sites.
  
  
  
  ClinicalTrials.gov NCT01064856.
authors.affiliation: From Rheumatology Research, Swedish Medical Center, and University of Washington School of Medicine, Seattle, Washington; Department of Medicine, University of Illinois at Chicago; Immunology Clinical Development, AbbVie Inc., Chicago, Illinois, USA; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Medicine I, Rheumatology, Charité Universitätsmedizin Berlin, Berlin, Germany. pmease@philipmease.com.|P.J. Mease has received research grants and consulting fees from Amgen, Lilly, Novartis, and Pfizer. F. Van den Bosch has received consultancy and/or speaker fees from Janssen, Novartis, and UCB. pmease@philipmease.com.|P.J. Mease, MD, Director, Rheumatology Research, Swedish Medical Center, and Clinical Professor, University of Washington School of Medicine; F. Van den Bosch, MD, PhD, Department of Rheumatology, Ghent University Hospital; J. Sieper, MD, PhD, Department of Medicine I, Rheumatology, Charité Universitätsmedizin Berlin; Y. Xia, PhD, Department of Medicine, University of Illinois at Chicago; A.L. Pangan, MD, Immunology Clinical Development, AbbVie Inc.; I.H. Song, MD, Immunology Clinical Development, AbbVie Inc. pmease@philipmease.com.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Mease
authors.affiliation: From Rheumatology Research, Swedish Medical Center, and University of Washington School of Medicine, Seattle, Washington; Department of Medicine, University of Illinois at Chicago; Immunology Clinical Development, AbbVie Inc., Chicago, Illinois, USA; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Medicine I, Rheumatology, Charité Universitätsmedizin Berlin, Berlin, Germany.|P.J. Mease has received research grants and consulting fees from Amgen, Lilly, Novartis, and Pfizer. F. Van den Bosch has received consultancy and/or speaker fees from Janssen, Novartis, and UCB.|P.J. Mease, MD, Director, Rheumatology Research, Swedish Medical Center, and Clinical Professor, University of Washington School of Medicine; F. Van den Bosch, MD, PhD, Department of Rheumatology, Ghent University Hospital; J. Sieper, MD, PhD, Department of Medicine I, Rheumatology, Charité Universitätsmedizin Berlin; Y. Xia, PhD, Department of Medicine, University of Illinois at Chicago; A.L. Pangan, MD, Immunology Clinical Development, AbbVie Inc.; I.H. Song, MD, Immunology Clinical Development, AbbVie Inc.
authors.forename: Filip
authors.initials: F
authors.lastname: Van den Bosch
authors.affiliation: From Rheumatology Research, Swedish Medical Center, and University of Washington School of Medicine, Seattle, Washington; Department of Medicine, University of Illinois at Chicago; Immunology Clinical Development, AbbVie Inc., Chicago, Illinois, USA; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Medicine I, Rheumatology, Charité Universitätsmedizin Berlin, Berlin, Germany.|P.J. Mease has received research grants and consulting fees from Amgen, Lilly, Novartis, and Pfizer. F. Van den Bosch has received consultancy and/or speaker fees from Janssen, Novartis, and UCB.|P.J. Mease, MD, Director, Rheumatology Research, Swedish Medical Center, and Clinical Professor, University of Washington School of Medicine; F. Van den Bosch, MD, PhD, Department of Rheumatology, Ghent University Hospital; J. Sieper, MD, PhD, Department of Medicine I, Rheumatology, Charité Universitätsmedizin Berlin; Y. Xia, PhD, Department of Medicine, University of Illinois at Chicago; A.L. Pangan, MD, Immunology Clinical Development, AbbVie Inc.; I.H. Song, MD, Immunology Clinical Development, AbbVie Inc.
authors.forename: Joachim
authors.initials: J
authors.lastname: Sieper
authors.affiliation: From Rheumatology Research, Swedish Medical Center, and University of Washington School of Medicine, Seattle, Washington; Department of Medicine, University of Illinois at Chicago; Immunology Clinical Development, AbbVie Inc., Chicago, Illinois, USA; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Medicine I, Rheumatology, Charité Universitätsmedizin Berlin, Berlin, Germany.|P.J. Mease has received research grants and consulting fees from Amgen, Lilly, Novartis, and Pfizer. F. Van den Bosch has received consultancy and/or speaker fees from Janssen, Novartis, and UCB.|P.J. Mease, MD, Director, Rheumatology Research, Swedish Medical Center, and Clinical Professor, University of Washington School of Medicine; F. Van den Bosch, MD, PhD, Department of Rheumatology, Ghent University Hospital; J. Sieper, MD, PhD, Department of Medicine I, Rheumatology, Charité Universitätsmedizin Berlin; Y. Xia, PhD, Department of Medicine, University of Illinois at Chicago; A.L. Pangan, MD, Immunology Clinical Development, AbbVie Inc.; I.H. Song, MD, Immunology Clinical Development, AbbVie Inc.
authors.forename: Yinglin
authors.initials: Y
authors.lastname: Xia
authors.affiliation: From Rheumatology Research, Swedish Medical Center, and University of Washington School of Medicine, Seattle, Washington; Department of Medicine, University of Illinois at Chicago; Immunology Clinical Development, AbbVie Inc., Chicago, Illinois, USA; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Medicine I, Rheumatology, Charité Universitätsmedizin Berlin, Berlin, Germany.|P.J. Mease has received research grants and consulting fees from Amgen, Lilly, Novartis, and Pfizer. F. Van den Bosch has received consultancy and/or speaker fees from Janssen, Novartis, and UCB.|P.J. Mease, MD, Director, Rheumatology Research, Swedish Medical Center, and Clinical Professor, University of Washington School of Medicine; F. Van den Bosch, MD, PhD, Department of Rheumatology, Ghent University Hospital; J. Sieper, MD, PhD, Department of Medicine I, Rheumatology, Charité Universitätsmedizin Berlin; Y. Xia, PhD, Department of Medicine, University of Illinois at Chicago; A.L. Pangan, MD, Immunology Clinical Development, AbbVie Inc.; I.H. Song, MD, Immunology Clinical Development, AbbVie Inc.
authors.forename: Aileen L
authors.initials: AL
authors.lastname: Pangan
authors.affiliation: From Rheumatology Research, Swedish Medical Center, and University of Washington School of Medicine, Seattle, Washington; Department of Medicine, University of Illinois at Chicago; Immunology Clinical Development, AbbVie Inc., Chicago, Illinois, USA; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Medicine I, Rheumatology, Charité Universitätsmedizin Berlin, Berlin, Germany.|P.J. Mease has received research grants and consulting fees from Amgen, Lilly, Novartis, and Pfizer. F. Van den Bosch has received consultancy and/or speaker fees from Janssen, Novartis, and UCB.|P.J. Mease, MD, Director, Rheumatology Research, Swedish Medical Center, and Clinical Professor, University of Washington School of Medicine; F. Van den Bosch, MD, PhD, Department of Rheumatology, Ghent University Hospital; J. Sieper, MD, PhD, Department of Medicine I, Rheumatology, Charité Universitätsmedizin Berlin; Y. Xia, PhD, Department of Medicine, University of Illinois at Chicago; A.L. Pangan, MD, Immunology Clinical Development, AbbVie Inc.; I.H. Song, MD, Immunology Clinical Development, AbbVie Inc.
authors.forename: In-Ho
authors.initials: IH
authors.lastname: Song
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use*; D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D000070676:Enthesopathy / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D025241:Spondylarthritis / Q000175:diagnosis* / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D000068879:Adalimumab
keywords: ADALIMUMAB; ENTHESITIS; PERIPHERAL SPONDYLOARTHRITIS