Biological DMARDs and disease modification in axial spondyloarthritis

Bibliographic Details
Main Author: Sepriano, Alexandre
Publication Date: 2021
Other Authors: Ramiro, Sofia, Van Der Heijde, Desirée, Landewé, Robert
Format: Other
Language: eng
Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
Download full: http://hdl.handle.net/10362/124277
Summary: Funding Information: Competing interests AS: Consulting/speaking fees from MSD, UCB, Novartis. SR: Research grant from MSD; Consultancy/speaking fees from AbbVie, Eli Lilly, MSD, Novartis, UCB, Sanofi. DvdH: Consulting fees AbbVie, Amgen, Astellas, AstraZeneca, Bayer, BMS, Boehringer Ingelheim, Celgene, Cyxone, Daiichi, Eisai, Eli-Lilly, Galapagos, Gilead, Glaxo-Smith-Kline, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi, Takeda, UCB Pharma Director of Imaging Rheumatology bv. RL: Consulting fees from AbbVie, BMS, Celgene, Eli-Lilly, Galapagos, Gilead, Glaxo-Smith-Kline, Janssen, Merck, Novartis, Pfizer, Roche, UCB and is Director of Rheumatology Consultancy bv Publisher Copyright: ©
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spelling Biological DMARDs and disease modification in axial spondyloarthritisA review through the lens of causal inferenceankylosingbiological therapyepidemiologyspondylitisImmunology and AllergyRheumatologyImmunologyFunding Information: Competing interests AS: Consulting/speaking fees from MSD, UCB, Novartis. SR: Research grant from MSD; Consultancy/speaking fees from AbbVie, Eli Lilly, MSD, Novartis, UCB, Sanofi. DvdH: Consulting fees AbbVie, Amgen, Astellas, AstraZeneca, Bayer, BMS, Boehringer Ingelheim, Celgene, Cyxone, Daiichi, Eisai, Eli-Lilly, Galapagos, Gilead, Glaxo-Smith-Kline, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi, Takeda, UCB Pharma Director of Imaging Rheumatology bv. RL: Consulting fees from AbbVie, BMS, Celgene, Eli-Lilly, Galapagos, Gilead, Glaxo-Smith-Kline, Janssen, Merck, Novartis, Pfizer, Roche, UCB and is Director of Rheumatology Consultancy bv Publisher Copyright: ©Axial spondyloarthritis (axSpA) is a chronic rheumatic disease characterised by inflammation predominantly involving the spine and the sacroiliac joints. In some patients, axial inflammation leads to irreversible structural damage that in the spine is usually quantified by the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). Available therapeutic options include biological disease-modifying antirheumatic drugs (bDMARDs), which have been proven effective in suppressing inflammation in several randomised controlled trials (RCT), the gold standard for evaluating causal treatment effects. RCTs are, however, unfeasible for testing structural effects in axSpA mainly due to the low sensitivity to change of the mSASSS. The available literature therefore mainly includes observational research, which poses serious challenges to the determination of causality. Here, we review the studies testing the effect of bDMARDs on spinal radiographic progression, making use of the principles of causal inference. By exploring the assumptions of causality under counterfactual reasoning (exchangeability, positivity and consistency), we distinguish between studies that likely have reported confounded treatment effects and studies that, on the basis of their design, have more likely reported causal treatment effects. We conclude that bDMARDs might, indirectly, interfere with spinal radiographic progression in axSpA by their effect on inflammation. Innovations in imaging are expected, so that placebo-controlled trials can in the future become a reality. In the meantime, causal inference analysis using observational data may contribute to a better understanding of whether disease modification is possible in axSpA.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNSepriano, AlexandreRamiro, SofiaVan Der Heijde, DesiréeLandewé, Robert2021-09-09T00:27:48Z2021-07-122021-07-12T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/otherapplication/pdfhttp://hdl.handle.net/10362/124277eng2044-6055PURE: 33432708https://doi.org/10.1136/rmdopen-2021-001654info:eu-repo/semantics/openAccessreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAP2024-05-22T17:55:59Zoai:run.unl.pt:10362/124277Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-28T17:26:55.826312Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse
dc.title.none.fl_str_mv Biological DMARDs and disease modification in axial spondyloarthritis
A review through the lens of causal inference
title Biological DMARDs and disease modification in axial spondyloarthritis
spellingShingle Biological DMARDs and disease modification in axial spondyloarthritis
Sepriano, Alexandre
ankylosing
biological therapy
epidemiology
spondylitis
Immunology and Allergy
Rheumatology
Immunology
title_short Biological DMARDs and disease modification in axial spondyloarthritis
title_full Biological DMARDs and disease modification in axial spondyloarthritis
title_fullStr Biological DMARDs and disease modification in axial spondyloarthritis
title_full_unstemmed Biological DMARDs and disease modification in axial spondyloarthritis
title_sort Biological DMARDs and disease modification in axial spondyloarthritis
author Sepriano, Alexandre
author_facet Sepriano, Alexandre
Ramiro, Sofia
Van Der Heijde, Desirée
Landewé, Robert
author_role author
author2 Ramiro, Sofia
Van Der Heijde, Desirée
Landewé, Robert
author2_role author
author
author
dc.contributor.none.fl_str_mv NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
RUN
dc.contributor.author.fl_str_mv Sepriano, Alexandre
Ramiro, Sofia
Van Der Heijde, Desirée
Landewé, Robert
dc.subject.por.fl_str_mv ankylosing
biological therapy
epidemiology
spondylitis
Immunology and Allergy
Rheumatology
Immunology
topic ankylosing
biological therapy
epidemiology
spondylitis
Immunology and Allergy
Rheumatology
Immunology
description Funding Information: Competing interests AS: Consulting/speaking fees from MSD, UCB, Novartis. SR: Research grant from MSD; Consultancy/speaking fees from AbbVie, Eli Lilly, MSD, Novartis, UCB, Sanofi. DvdH: Consulting fees AbbVie, Amgen, Astellas, AstraZeneca, Bayer, BMS, Boehringer Ingelheim, Celgene, Cyxone, Daiichi, Eisai, Eli-Lilly, Galapagos, Gilead, Glaxo-Smith-Kline, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi, Takeda, UCB Pharma Director of Imaging Rheumatology bv. RL: Consulting fees from AbbVie, BMS, Celgene, Eli-Lilly, Galapagos, Gilead, Glaxo-Smith-Kline, Janssen, Merck, Novartis, Pfizer, Roche, UCB and is Director of Rheumatology Consultancy bv Publisher Copyright: ©
publishDate 2021
dc.date.none.fl_str_mv 2021-09-09T00:27:48Z
2021-07-12
2021-07-12T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/other
format other
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/124277
url http://hdl.handle.net/10362/124277
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 2044-6055
PURE: 33432708
https://doi.org/10.1136/rmdopen-2021-001654
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron:RCAAP
instname_str FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron_str RCAAP
institution RCAAP
reponame_str Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
collection Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
repository.name.fl_str_mv Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
repository.mail.fl_str_mv info@rcaap.pt
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