A Study Of Sacroiliac Joint MRI SPARCC/SSS Score Change Before And After Etanercept Therapy In Twenty Active Patients With Ankylosing Spondylitis

Objectives:This paper is studying the sacroiliac joint Magnetic Resonance Imaging (MRI) SPARCC/SSS score changes of active ankylosing spondylitis (AS) patients after they get the Etanercept treatment and explore its role in the disease evaluation and curative effect analysis.Methods:Collecting active AS patients (n=20),treated with etanercept and sulfasalazine and thalidomide in the first 12 weeks, the following 12 weeks (n=12) were randomly divided into A, B two groups, group A (n=8) continue to use the original treatment, group B (n=4) discontinued etanercept.The patients get sacroiliac joint MRI examination for the 0th,12th and 24th week.Two rheumatologists and two radiologists make double blind SPARCC and SSS score for the imaging data.Also,this paper should collect the same period scores and other information for ESR、CRP、BASDAI、BASFI、BASMI、 ASDAS-CRP.This paper used SPSS statistical software to analyze the SPARCC and SSS score difference at different time points,the correlation of the variation difference before and after the treatment and variation difference of other clinical indexes.Results:(1)At the 0th and 12th week,20 cases of patients SPARCC score respectively21.5(8,31.5),2.5(0.75,17.5),the difference is statistically significant (P<0.05). (2)At the 0th and the 12th week,20 cases of patients with SSS score respectively 24.70±11.06、24.85±10.78, at the 24th week, patients of group A with SSS score 29.75±15.67 and group B patients score 25.25±8.62,which are not statistically significant compared with then (P>0.05).(3) SPARCC scores for patients of group A and B,12th week and 24th week, respectively, compared with 0th week, statistically significant difference (P< 0.05), compared 24th week with 12th week, there were no statistically significant difference(P>0.05); SSS scores for patients of group A and B,12th week and 24th week, respectively, compared with 0th week, and compared 24th with 12th week, there were no statistically significant difference (P> 0.05); SPARCC and SSS scores for patients of group A and B are not statistically significant(P> 0.05).(4) BASDAI, BASFI,ASDAS, CRP and ESR average of 20 patients,the differences were statistically significant(P< 0.05). (5)Sacroiliac joint MRI SPARCC score, SSS score and BASDAI, BASFI,BASMI,CRP, ESR,ASDAS-CRP indexes are uncorrelated, MRI SPARCC score and SSS score are uncorrelated. (6)Safety: during the period of 24 weeks of follow-up,the patients had no adverse events such as drug injection reactions at the injection site, blood routine, liver and kidney function were no obvious abnormalities.Conclusion:1.Etanercept treatment for 24 weeks,the sacroiliac joint bone marrow edema decreased,MRI SPARCC score decreased for patients with active ankylosing spondylitis (AS), SPARCC can be used as an reference index to assess efficacy.2.Etanercept treatment for 24 weeks,sacroiliac joint structure of active AS patients had no obvious change.3.Etanercept treatment for active AS patients,have a better effect in clinical control than traditional therapy,and good safety.