Table 3.

Development of new syndesmophytes on radiographs of anterior cervical and lumbar spine in 50 patients with AS treated with TNF-α inhibitors or standard therapy. Data are from concordant and individual reads and show number (%) of anterior vertebral corners associated with the presence or absence of new syndesmophytes.

TNF-α Inhibitor Therapy, n = 23 New Syndesmophytes at Followupp*Standard Therapy, n = 27 New Syndesmophytes at Followupp*
YesNoYesNo
Concordant Reads
  Baseline MRI
    Vertebral corner with CIL3 (16.7)15 (83.3)0.013 (15.0)17 (85.0)0.03
    Vertebral corner without CIL7 (2.2)300 (97.7)16 (3.2)478 (96.8)
  Followup MRI
    Completely resolved CIL3 (42.9)4 (57.1)0.0009††1 (20.0)4 (80.0)††0.16††
    Persistent CIL0(0)4 (100)0.76**0 (0)10 (100)0.56**
    No CIL7 (2.4)287 (97.6)16 (3.3)469 (96.7)
    New CIL at followup13
First reads
  Baseline MRI
    Vertebral corner with CIL4 (7.5)49 (92.5)0.083 (5.8)49 (94.2)0.43
    Vertebral corner without CIL8 (2.5)312 (97.5)16 (3.2)488 (96.8)
  Followup MRI
    Completely resolved CIL4 (15.4)22 (84.6)0.009††2 (10.6)17 (89.5)††0.14††
    Persistent CIL0 (0)27 (100)0.40**1 (3.0)32 (97.0)**0.95**
    No CIL8 (2.6)303 (97.4)16 (3.2)481 (96.8)
    New CIL at followup97
Second reads
  Baseline MRI
    Vertebral corner with CIL4 (12.9)27 (87.1)0.013 (10.0)27 (90.0)0.08
    Vertebral corner without CIL8 (2.3)334 (97.7)16 (3.0)510 (97.0)
  Followup MRI
    Completely resolved CIL4 (15.4)22 (84.6)0.007††2 (11.1)16 (88.9)0.12††
    Persistent CIL0 (0)5 (100)0.73**1 (7.6)12 (92.3)0.35**
    No CIL8 (2.4)327 (97.6)16 (3.1)502 (96.9)
    New CIL at followup77
  • * Pearson chi-squared test.

  • Compared to vertebral corners without a CIL baseline.

  • †† Comparison of new syndesmophytes developing in vertebral corners with a CIL that has completely resolved on followup MRI vs those vertebral corners with no CIL on either baseline or followup MRI scan.

  • ** Comparison of new syndesmophytes developing in vertebral corners with a CIL that is present on both baseline and followup MRI vs those vertebral corners where there is no CIL on either MRI scan. CIL: corner inflammatory lesions; MRI: magnetic resonance imaging; TNF-α: tumor necrosis factor-α. Reader 1: PC; Reader 2: SJP; standard therapy included NSAID and physical therapy.