Modification of structural lesions on MRI of the sacroiliac joints by etanercept in the EMBARK trial: a 12-week randomised placebo-controlled trial in patients with non-radiographic axial spondyloarthritis.
在开始试验中,依那西普对骶髂关节 MRI 结构损伤的修改: 一项针对非放射学轴性脊柱关节炎患者的 12 周随机安慰剂对照试验。

摘要

OBJECTIVE:To evaluate the impact on structural lesions observed on MRI in the sacroiliac joints (SIJ) at 12 weeks in patients with non-radiographic axial spondyloarthritis (nr-axSpA) receiving etanercept or placebo in EMBARK (Effect of Etanercept on Symptoms and Objective Inflammation in nr-axSpA, a 104 week study).
METHODS:Patients were randomised to double-blind etanercept 50 mg/week or placebo for 12 weeks. Structural lesions at baseline and 12 weeks were scored by two independent readers using the Spondyloarthritis Research Consortium of Canada (SPARCC) SIJ structural score (SSS) on T1-weighted MRI. Change in SPARCC SSS and correlation with improvement in clinical outcomes was evaluated.
RESULTS:MRI scans from 185 patients (etanercept, n=88; placebo, n=97) were reviewed. At baseline, there were no significant differences in mean SPARCC SSS between etanercept and placebo. From baseline to 12 weeks, change in mean SPARCC SSS was significantly greater for etanercept than placebo for erosion (-0.57 vs -0.08, respectively, adjusted p value=0.017) and backfill (0.36 vs 0.06, adjusted p value=0.022). A treatment difference was also present for the subgroup of patients with SIJ inflammation on MRI (SPARCC bone marrow oedema ≥2): erosion: -0.81 versus -0.13 for etanercept versus placebo, respectively, p=0.007; backfill: 0.48 versus 0.08, respectively, p=0.032. Decrease in erosion and increase in backfill correlated with improvement in more clinical outcomes for etanercept than placebo.
CONCLUSION:Treatment with etanercept was associated with significantly greater reduction in erosions and increase in backfill at 12 weeks compared with placebo, consistent with a very early reparative response to antitumour necrosis factor therapy. The impact on disease progression in spondyloarthritis should be studied further.
TRIAL REGISTRATION NUMBER:NCT01258738; Post-results.

译文

目的: 评估对非放射学的中轴脊柱关节炎 (nr-axSpA) 患者在 12 周时骶髂关节 (SIJ) MRI 上观察到的结构损伤的影响接受依那西普或安慰剂 (依那西普对 nr-axSpA 的症状和客观炎症的影响,一项 104 周的研究)。
方法: 患者被随机分为双盲依那西普 50 mg/周或安慰剂组,为期 12 周。两名独立读者使用加拿大脊柱关节炎研究联盟 (SPARCC) SIJ 结构评分 (SSS) 对基线和 12 周的结构 T1-weighted MRI 进行评分。评估了 SPARCC SSS 的变化以及与临床结果改善的相关性。
结果: 对 185 名患者 (依那西普,n = 88; 安慰剂,n = 97) 的 MRI 扫描进行了审查。在基线时,依那西普和安慰剂在平均 SPARCC SSS 上没有显著差异。从基线到 12 周,依那西普的平均 SPARCC SSS 变化明显大于安慰剂的侵蚀变化 (分别为-0.57 vs-0.08,调整后 p值 = 0.017) 和回填 (0.36 对 0.06,调整后的 p值 = 0.022)。MRI (SPARCC 骨髓水肿 ≥ 2) 的 SIJ 炎症患者亚组也存在治疗差异: 依那西普与安慰剂的侵蚀分别为-0.81 与-0.13, p = 0.007; 回填: 分别为 0.48 和 0.08,p = 0.032。与安慰剂相比,侵蚀的减少和回填的增加与依那西普更多临床结果的改善相关。
结论: 与安慰剂相比,依那西普治疗 12 周时侵蚀显著减少,回填增加,与对抗坏死因子治疗的早期修复反应一致。对脊柱关节炎疾病进展的影响应该进一步研究。
试验注册号: NCT01258738; 后结果。

Sacroiliac

骨科 滑膜关节 临床研究术语
概述  :  

骶髂关节是一种滑膜关节,位于骶骨、髂骨耳状面之间,左右各一。成人关节软骨表层为纤维软骨,深层为透明软骨,老年人此关节可以完全纤维化。 解剖基础 骶髂关节的结构具有双重性,一部分属于纤维连结,另一部分属于滑膜连结。骶粗隆与髂粗隆之间的缝隙由纤维所填充,能承受压力、传递重力以及缓冲支撑反作用力。该部位韧带除了人体在卧位状态外,经常处于重压之下,易于损伤,一旦骶髂关节纤维部损伤,滑膜连结难以维持关节的完整性。   解剖

Sacroiliac 英 /,seɪkrəʊ'ɪlɪæk; ,sæk-/  美 /,sækro'ɪlɪæk/             

释义   adj. 骶髂的;骶髂关节的

n. 骶骼骨关节

例句   But it's smart to learn proper technique, especially when it comes to your inner knees, hamstring tendons, and sacroiliac joints. 尽管如此,提前学习一些保护自己的技巧还是明智之选,特别是关于膝盖,大腿肌腱和骶髂关节。

请扫描右侧二维码,免费查看词汇专业知识背景