Christian E. Althoff MD, Presenter: Nothing to Disclose

Hildrun Haibel MD, Abstract Co-Author: Nothing to Disclose

Kay-Geert A. Hermann MD, Abstract Co-Author: Nothing to Disclose

Joachim Sieper, Abstract Co-Author: Nothing to Disclose

Hartmut Kupper, Abstract Co-Author: Employee, Abbott Laboratories

Martin Rudwaleit MD, PhD, Abstract Co-Author: Nothing to Disclose

Adalimumab is highly effective in reducing signs and symptoms in active AS. This study evaluates the feasibility to display the effects of adalimumab on spinal and sacroiliac joint (SI-Joint) inflammation after 12 weeks of therapy with the Berlin MRI Spine Score (BMSS) and the Hermann/Bollow Sacroiliac Joint Score (HBSJS).

MRI was performed in 59 patients from 8 German centers participating in a multinational, prospective, open-label trial (RHAPSODY). Adult patients with active AS (Bath Ankylosing spondylitis activity index >=4) received adalimumab 40 mg subcutaneous every other week for 12 weeks. MRI of the spine and the SI joints were performed at baseline and after 12 weeks of adalimumab. Active inflammation in the spine was scored according to the BMSS, evaluating the extent of bone marrow edema (BME) of 23 dicovertebral units with a score of 0-3 (0-69). The SI joints were scored according to the HBSJS, dividing each joint in 4 quadrants and evaluating the BME with a score of 0-4 (0-32). MRIs were scored independently by two readers blinded for the time point of MRI investigation. The mean of all scores of the two readers were taken for analysis.

A BMSS of >=1 was found in 71.2% of the 59 patients ranging from 1 to 42. A score of >=10 (reflecting extended spinal inflammation) was found in 22% of the 59 patients. The mean (SD) BMSS of 6.04 (7.83) at baseline dropped to 3.19 (4.57) after 12 weeks of adalimumab therapy (p=1) was found in 79.7% of the patients, the scores ranging from 1-25. 23.7% of patients had a score of >=8. The mean (SD) HBSJS score dropped from 5.53 (6.10) at baseline to 3.48 (3.40) after 12 weeks (p=0.001), reflecting a significant improvement in the SI joints by 37%.

The BMSS and HBSJS showed a significant reduction of active inflammatory lesions in both the spine and in the SI joints already after 12 weeks of therapy with Adalimumab.

The Berlin MRI Spine Score and the Hermann/Bollow Sacroiliac Joint Score are feasible to show short term therapy effects in patients with active AS under therapy of Adalimumab.

Althoff, C, Haibel, H, Hermann, K, Sieper, J, Kupper, H, Rudwaleit, M, Evaluation of Two MRI Scoring Systems for Short Term Follow-up Analysis for the Reduction of Inflammation in the Spine and in the Sacroiliac Joints in Active Ankylosing Spondylitis (AS) after Therapy with Adalimumab.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5013893.html