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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">It has been shown that no anti-TNF biologic drug inhibits or retards radiographic progression at 2 years in patients with ankylosing spondylitis &#40;who met the New York criteria&#41; when compared with historical cohorts such as OASIS&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;3</span></a> There are no published studies evaluating the effect of biologic therapy on structural progression in patients with non-radiographic axial spondyloarthritis&#46; In studies evaluating radiological progression&#44; patients do not receive anti-TNF-&#945; or do it in a very small percentage&#46; In 2 recent GESPIC cohort studies that assess the progression in the spine and sacroiliac joints of 95 patients with non-radiographic axial spondyloarthritis&#44; only one patient received biological therapy&#46; In these studies&#44; 10&#46;5&#37; of patients showed progression of sacroiliitis and 7&#46;4&#37;&#44; had spinal progression at 2 years follow-up&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The aim of this study was to evaluate the radiological progression in spine and sacroiliac joints at 2 years in a cohort of patients with non radiographic axial spondyloarthritis treated with anti-TNF-&#945;&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">After a systematic review of medical records&#44; we selected all patients with non radiological axial spondyloarthritis in our service and biological treatment with anti-TNF drugs at a standard dose for a minimum of two years and who had a baseline simple X-ray of the spine &#40;cervical and lumbar lateral projection&#41; and pelvis &#40;anteroposterior view&#41;&#44; and a follow-up X-ray 2 years later under the same treatment&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">All selected patients&#44; 19&#44; fulfilled the ASAS classification criteria for axial spondyloarthritis&#44;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> but did not meet the New York radiological criteria for ankylosing spondylitis<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> &#40;bilateral sacroiliitis at least grade 2 or unilateral grade 3&#8211;4&#41;&#46;The 19 patients met the 2 entrnace criteria &#40;back pain &#8805;three months and age of onset &#60;45 years&#41;&#44; 13 &#40;65&#37;&#41; met the HLAB27 criteria and 6 &#40;35&#37;&#41; the imaging&#44; and thus&#44; had acute inflammation on MRI&#44; indicating sacroiliitis&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">We excluded patients with cutaneous psoriasis and inflammatory bowel disease&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Twelve patients received adalimumab&#44; 2 infliximab&#44; and 5 etanercept&#46; Only 2 patients &#40;10&#46;5&#37;&#41; received concomitant therapy with NSAIDs for 3 or more months&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The baseline characteristics of the patients are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Two trained readers&#44; JL and MA&#44; examined the spinal radiographs according to the Stoke Ankylosing Spondylitis Spine Score &#40;mSASSS&#41;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> and the sacroiliac joint x rays according to the grading system of the modified New York criteria for ankylosing spondylitis<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> in chronological order &#40;baseline and follow-up at 2 years with the same biological treatment&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The intraclass correlation coefficients &#40;ICC&#41; for baseline rates were 1 in mSASSS and 0&#46;4 index in grading the sacroiliac index and the ICC for the change rates were 1 in both reading systems&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The mSASSS index was zero units at baseline and at 2 years of treatment in all patients &#40;none developed structural lesions in the spine&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">There was no sacroiliac radiological progression in any patient&#46; None of the 19 patients in the cohort met the New York criteria for ankylosing spondylitis after 2 years of biological therapy with anti-TNF-&#945;&#8901;</p><p id="par0060" class="elsevierStylePara elsevierViewall">In conclusion&#44; none of the patients in our cohort with non radiographic axial spondyloarthritis showed radiographic progression in the spine or sacroiliac joints after 2 years of treatment with anti-TNF&#44; unlike other non-radiological spondylitis cohorts without biological therapy&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">In the first GESPIC cohort study&#44; assessing sacroiliac radiographic progression at 2 years&#44; the only predictor of radiographic progression were baseline CRP levels&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> In our cohort&#44; 47&#46;4&#37; of patients had CRP levels greater than 0&#46;6<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#46; In this study by Poddubnyy et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> the high level of CRP was also a significant predictor of progression of non-radiological spondylitis to ankylosing spondylitis and the presence of structural damage defined at baseline was also associated with greater progression to ankylosing spondylitis&#44; although not statistically significant&#46; In another study&#44; Huerta-Sil et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> also found that low-grade sacroiliitis was a prognostic factor for the development of spondylitis&#46; In our cohort&#44; 47&#46;4&#37; of patients had low-grade structural damage &#40;grade I unilateral or bilateral sacroiliitis and&#47;or unilateral grade II&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">In the second GESPIC<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> cohort study evaluating spinal radiographic progression at 2 years&#44; only the presence of basal syndesmophytes was a statistically significant predictor of progression in the non radiological spondylitis group&#44; although there were was radiological progression in patients with no baseline syndesmophytes &#40;the vast majority&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">In our cohort of patients&#44; although they presented no baseline syndesmophytes&#44; the fact that they showed no radiographic spinal or sacroilliac progression indicates that anti-TNF therapy may inhibit or delay progression in patients with axial non-radiological ankylosing spondylitis&#44; although further studies are necessary with control groups and more patients&#46; This data indicates the existence of a window of opportunity in which an effective treatment may alter the course of disease&#46;</p></span>"
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">5&#46;89&#177;5&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Male gender&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">10 &#40;52&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">HLAB27&#43;&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">15 &#40;78&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Smokers&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">7 &#40;36&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Peripheral arthritis&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;84&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Enthesitis&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;36&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Dactylitis&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1 &#40;5&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Uveitis&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">5 &#40;26&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Family history of spondylitis&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7 &#40;36&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">BASDAI&#62;4&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">19 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">PCR&#62;0&#46;6<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">9 &#40;47&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">ESR&#62;20<span class="elsevierStyleHsp" style=""></span>mm&#47;h&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">8 &#40;42&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Structural damage defined in sacroiliac joints &#40;grade I unilateral or bilateral sacroiliitis and&#47;or unilateral grade II&#41;&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">9 &#40;47&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t">Defined spinal structural damage &#40;mSASSS&#8805;1&#41;&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Baseline Characteristics of Patients With Non-Radiographic Axial Spondyloarthritis&#46;</p>"
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        0 => array:2 [
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Radiographic findings following two years of infliximab therapy in patients with ankylosing spondylitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            2 => "X&#46; Baraliakos"
                            3 => "H&#46; Houben"
                            4 => "A&#46; van Tubergen"
                            5 => "P&#46; Williamson"
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                    0 => array:2 [
                      "doi" => "10.1002/art.23901"
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                        "tituloSerie" => "Arthritis Rheum"
                        "fecha" => "2008"
                        "volumen" => "58"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18821688"
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                0 => array:2 [
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                      "titulo" => "Radiographic progression of ankylosing spondylitis after up to two years of treatment with etanercept"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            2 => "S&#46; Einstein"
                            3 => "P&#46; Ory"
                            4 => "D&#46; Vosse"
                            5 => "L&#46; Ni"
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                  ]
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                    0 => array:2 [
                      "doi" => "10.1002/art.23471"
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                        "volumen" => "58"
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                0 => array:2 [
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                      "titulo" => "Assessment of radiographic progression in the spines of patients with ankylosing spondylitis treated with adalimumab for up to 2 years"
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                        0 => array:2 [
                          "etal" => true
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                            4 => "W&#46;P&#46; Maksymowych"
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                      "doi" => "10.1186/ar2794"
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                        "tituloSerie" => "Arthritis Res Ther"
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                      "titulo" => "Baseline radiographic damage&#44; elevated acute-phase reactant levels&#44; and cigarette smoking status predict spinal radiographic progression in early axial spondylarthritis"
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                      "doi" => "10.1002/art.33465"
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                            5 => "J&#46; Brandt"
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                        "paginaInicial" => "777"
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                            3 => "R&#46; Rivas-Ruiz"
                            4 => "J&#46; Ch&#225;vez"
                            5 => "C&#46; Pacheco-Tena"
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                      "doi" => "10.1136/ard.2005.043471"
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                        "tituloSerie" => "Ann Rheum Dis"
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                        "volumen" => "65"
                        "paginaInicial" => "642"
                        "paginaFinal" => "646"
                        "link" => array:1 [
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Letter to the Editor
Absence of Radiographic Progression at Two Years in a Cohort of Patients With Non-radiographic Axial Spondyloarthritis Treated With TNF-α Blockers
Ausencia de progresión radiológica a los 2 años en una cohorte de pacientes con espondiloartritis axial no radiológica tratados con terapia anti-TNF-α
Miriam Almirall
Corresponding author
reu0802@parcdesalutmar.cat

Corresponding author.
, Josue Guillermo López-Velandia, Joan Maymó
Servicio de Reumatología, Parc de Salut Mar, Barcelona, Spain
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        "titulo" => "Ausencia de progresi&#243;n radiol&#243;gica a los 2 a&#241;os en una cohorte de pacientes con espondiloartritis axial no radiol&#243;gica tratados con terapia anti-TNF-<span class="elsevierStyleBold">&#945;</span>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">It has been shown that no anti-TNF biologic drug inhibits or retards radiographic progression at 2 years in patients with ankylosing spondylitis &#40;who met the New York criteria&#41; when compared with historical cohorts such as OASIS&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;3</span></a> There are no published studies evaluating the effect of biologic therapy on structural progression in patients with non-radiographic axial spondyloarthritis&#46; In studies evaluating radiological progression&#44; patients do not receive anti-TNF-&#945; or do it in a very small percentage&#46; In 2 recent GESPIC cohort studies that assess the progression in the spine and sacroiliac joints of 95 patients with non-radiographic axial spondyloarthritis&#44; only one patient received biological therapy&#46; In these studies&#44; 10&#46;5&#37; of patients showed progression of sacroiliitis and 7&#46;4&#37;&#44; had spinal progression at 2 years follow-up&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The aim of this study was to evaluate the radiological progression in spine and sacroiliac joints at 2 years in a cohort of patients with non radiographic axial spondyloarthritis treated with anti-TNF-&#945;&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">After a systematic review of medical records&#44; we selected all patients with non radiological axial spondyloarthritis in our service and biological treatment with anti-TNF drugs at a standard dose for a minimum of two years and who had a baseline simple X-ray of the spine &#40;cervical and lumbar lateral projection&#41; and pelvis &#40;anteroposterior view&#41;&#44; and a follow-up X-ray 2 years later under the same treatment&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">All selected patients&#44; 19&#44; fulfilled the ASAS classification criteria for axial spondyloarthritis&#44;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> but did not meet the New York radiological criteria for ankylosing spondylitis<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> &#40;bilateral sacroiliitis at least grade 2 or unilateral grade 3&#8211;4&#41;&#46;The 19 patients met the 2 entrnace criteria &#40;back pain &#8805;three months and age of onset &#60;45 years&#41;&#44; 13 &#40;65&#37;&#41; met the HLAB27 criteria and 6 &#40;35&#37;&#41; the imaging&#44; and thus&#44; had acute inflammation on MRI&#44; indicating sacroiliitis&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">We excluded patients with cutaneous psoriasis and inflammatory bowel disease&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Twelve patients received adalimumab&#44; 2 infliximab&#44; and 5 etanercept&#46; Only 2 patients &#40;10&#46;5&#37;&#41; received concomitant therapy with NSAIDs for 3 or more months&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The baseline characteristics of the patients are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Two trained readers&#44; JL and MA&#44; examined the spinal radiographs according to the Stoke Ankylosing Spondylitis Spine Score &#40;mSASSS&#41;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> and the sacroiliac joint x rays according to the grading system of the modified New York criteria for ankylosing spondylitis<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> in chronological order &#40;baseline and follow-up at 2 years with the same biological treatment&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The intraclass correlation coefficients &#40;ICC&#41; for baseline rates were 1 in mSASSS and 0&#46;4 index in grading the sacroiliac index and the ICC for the change rates were 1 in both reading systems&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The mSASSS index was zero units at baseline and at 2 years of treatment in all patients &#40;none developed structural lesions in the spine&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">There was no sacroiliac radiological progression in any patient&#46; None of the 19 patients in the cohort met the New York criteria for ankylosing spondylitis after 2 years of biological therapy with anti-TNF-&#945;&#8901;</p><p id="par0060" class="elsevierStylePara elsevierViewall">In conclusion&#44; none of the patients in our cohort with non radiographic axial spondyloarthritis showed radiographic progression in the spine or sacroiliac joints after 2 years of treatment with anti-TNF&#44; unlike other non-radiological spondylitis cohorts without biological therapy&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">In the first GESPIC cohort study&#44; assessing sacroiliac radiographic progression at 2 years&#44; the only predictor of radiographic progression were baseline CRP levels&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> In our cohort&#44; 47&#46;4&#37; of patients had CRP levels greater than 0&#46;6<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#46; In this study by Poddubnyy et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> the high level of CRP was also a significant predictor of progression of non-radiological spondylitis to ankylosing spondylitis and the presence of structural damage defined at baseline was also associated with greater progression to ankylosing spondylitis&#44; although not statistically significant&#46; In another study&#44; Huerta-Sil et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> also found that low-grade sacroiliitis was a prognostic factor for the development of spondylitis&#46; In our cohort&#44; 47&#46;4&#37; of patients had low-grade structural damage &#40;grade I unilateral or bilateral sacroiliitis and&#47;or unilateral grade II&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">In the second GESPIC<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> cohort study evaluating spinal radiographic progression at 2 years&#44; only the presence of basal syndesmophytes was a statistically significant predictor of progression in the non radiological spondylitis group&#44; although there were was radiological progression in patients with no baseline syndesmophytes &#40;the vast majority&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">In our cohort of patients&#44; although they presented no baseline syndesmophytes&#44; the fact that they showed no radiographic spinal or sacroilliac progression indicates that anti-TNF therapy may inhibit or delay progression in patients with axial non-radiological ankylosing spondylitis&#44; although further studies are necessary with control groups and more patients&#46; This data indicates the existence of a window of opportunity in which an effective treatment may alter the course of disease&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Almirall M&#44; L&#243;pez-Velandia JG&#44; Maym&#243; J&#46; Ausencia de progresi&#243;n radiol&#243;gica a los 2 a&#241;os en una cohorte de pacientes con espondiloartritis axial no radiol&#243;gica tratados con terapia anti-TNF-&#945;&#46; Reumatol Clin&#46; 2014&#59;10&#58;134&#8211;135&#46;</p>"
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                  \t\t\t\t" style="border-bottom: 2px solid black">Patients with non-radiographic axial spondyloarthritis &#40;n&#61;19&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age&#44; mean&#177;SD &#40;years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#46;9&#177;7&#46;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Duration of symptoms&#44; mean&#177;SD &#40;years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;89&#177;5&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Male gender&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;52&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HLAB27&#43;&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;78&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Smokers&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;36&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Peripheral arthritis&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;84&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enthesitis&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;36&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dactylitis&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;5&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Uveitis&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;26&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Family history of spondylitis&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;36&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BASDAI&#62;4&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PCR&#62;0&#46;6<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;47&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ESR&#62;20<span class="elsevierStyleHsp" style=""></span>mm&#47;h&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;42&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Structural damage defined in sacroiliac joints &#40;grade I unilateral or bilateral sacroiliitis and&#47;or unilateral grade II&#41;&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;47&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Defined spinal structural damage &#40;mSASSS&#8805;1&#41;&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Baseline Characteristics of Patients With Non-Radiographic Axial Spondyloarthritis&#46;</p>"
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      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
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              "identificador" => "bib0005"
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                  "contribucion" => array:1 [
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                      "autores" => array:1 [
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                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Van der Heijde"
                            1 => "R&#46; Landew&#233;"
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                      "doi" => "10.1002/art.23901"
                      "Revista" => array:6 [
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                          "autores" => array:6 [
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                            3 => "R&#46; Landew&#233;"
                            4 => "W&#46;P&#46; Maksymowych"
                            5 => "H&#46; Kupper"
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/ar2794"
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                      "titulo" => "Rates and predictors of radiographic sacroiliitis progression over 2 years in patients with axial spondyloarthritis"
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                            4 => "E&#46; M&#228;rker-Hermann"
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                      "titulo" => "Baseline radiographic damage&#44; elevated acute-phase reactant levels&#44; and cigarette smoking status predict spinal radiographic progression in early axial spondylarthritis"
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                      "doi" => "10.1002/art.33465"
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                      "titulo" => "The development of Assessment of Spondyloarthritis International Society classification criteria for axial spondyloarthritis &#40;part II&#41;&#58; validation and final selection"
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                        0 => array:2 [
                          "etal" => true
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                            2 => "R&#46; Landew&#233;"
                            3 => "J&#46; Listing"
                            4 => "N&#46; Akkoc"
                            5 => "J&#46; Brandt"
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                    ]
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                    0 => array:2 [
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                0 => array:2 [
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                      "titulo" => "Evaluation of diagnostic criteria for ankylosing spondylitis&#46; A proposal for modification of the New York criteria"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
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                  ]
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                    0 => array:1 [
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                        "tituloSerie" => "Arthritis Rheum"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "What is the most appropriate radiologic scoring method for ankylosing spondylitis&#63; A comparison of the available methods based on the Outcome Measures in Rheumatology Clinical Trials filter"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;J&#46; Wanders"
                            1 => "R&#46;B&#46; Landew&#233;"
                            2 => "A&#46; Spoorenberg"
                            3 => "M&#46; Dougados"
                            4 => "S&#46; van der Linden"
                            5 => "H&#46; Mielants"
                          ]
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                      ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/art.20446"
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                        "paginaInicial" => "2622"
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              "etiqueta" => "9"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Low grade radiographic sacroiliitis as pronostic factor in patients with undifferentiated spondyloarthritis fulfilling diagnostic criteria for ankylosing spondylitis throughout follow up"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Huerta-Sil"
                            1 => "J&#46;C&#46; Casasola-Vargas"
                            2 => "J&#46;D&#46; Londo&#241;o"
                            3 => "R&#46; Rivas-Ruiz"
                            4 => "J&#46; Ch&#225;vez"
                            5 => "C&#46; Pacheco-Tena"
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                      ]
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                  ]
                  "host" => array:1 [
                    0 => array:2 [
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Article information
ISSN: 21735743
Original language: English
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Idiomas
Reumatología Clínica (English Edition)
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