Biological DMARDs and disease modification in axial spondyloarthritis
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Publication Date: | 2021 |
Other Authors: | , , |
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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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 |
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info:eu-repo/semantics/publishedVersion |
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http://hdl.handle.net/10362/124277 |
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http://hdl.handle.net/10362/124277 |
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eng |
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eng |
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2044-6055 PURE: 33432708 https://doi.org/10.1136/rmdopen-2021-001654 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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