On the subject of radiographic progression while on treatment, Dr. Deodhar noted that the traditional teaching has been that medications like TNF inhibitors do not prevent structural progression of disease. However, more recent studies have challenged this dogma. Dr. Deodhar noted that structural progression and inflammation are coupled in axial spondyloarthritis, and effective control of inflammation appears to reduce the rate of structural progression, at least as shown by retrospective observational cohort studies.
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Prospective randomized clinical trials are the only gold standard method by which to confirm a cause-and-effect relationship between the use of biologics and inhibition of structural damage, and head-to-head clinical trials would be helpful in comparing the effects of different biologics against one another.
This lecture on ankylosing spondylitis and nr-axSpA was thought-provoking and clarified common misconceptions about these conditions.
Jason Liebowitz, MD, completed his fellowship in rheumatology at Johns Hopkins University, Baltimore, where he also earned his medical degree. He is currently in practice with Skylands Medical Group, N.J.
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