Improving SpA outcomes: Role of Imaging and Real World Evidence
This symposium will discuss the role of imaging in the diagnosis and management of spondyloarthritis (SpA). As clinical signs and laboratory tests are typically not sufficiently sensitive to determine the degree of inflammatory arthritis, imaging can be a key component in the objective assessment of SpA. Various imaging modalities, such as conventional radiography (CR), ultrasound (US), conventional computed tomography (CT), spectral CT, bone scintigraphy, and magnetic resonance imaging (MRI), have been used to aid in diagnosis, monitor disease activity, observe and predict structural changes and assess treatment response. For example, CR can reliably demonstrate New York criteria grade 2 bilateral or grade 3-4 unilateral sacroiliitis, while US is mainly used for enthesitis and synovitis in appendicular joints. Conventional CT allows visualization of erosions, sclerosis, and new bone formation whereas spectral CT may be able to detect oedema from active sacroiliitis. MRI can identify not only pre-radiographic disease, specifically enthesitis and active sacroiliitis, but also structural damage to the sacroiliac joints. In particular, the question of whether imaging can be used to decide on the intensity of SpA treatments will be addressed.
Further, the value and implications of real world evidence on clinical practice will be examined. Compared to randomized controlled trials (RCTs), collecting data from routine care in registries and other real-world data sources offer a number of advantages. Unlike RCT populations that are highly selected, registry populations are more representative of the “real world’ and include patient conditions and subpopulations often excluded in RCTs. This provides higher patient numbers, allows the detection of rare complications and potentially gives better estimates of treatment effects in clinical practice. However, the downsides include uncontrolled and/or undetectable confounders, lack of randomization of subjects, and inconsistent quality of data, when compared with RCTs. We will also discuss guidelines for registry processes and evidence from the Korean registry will be used as a practical illustration.
Ping-Ning HSU, Taiwan
Joung-Liang LAN, Taiwan
Sergio SCHWARTZMAN, United States
Kichul SHIN, Korea
|1730||Welcome and introductions||Ping-Ning HSU|
|1730||Imaging in the diagnosis and management of SpA||Sergio SCHWARTZMAN||Ping-Ning HSU|
|1800||Real world evidence in the management of SpA patients||Kichul SHIN||Joung-Liang LAN|
|1825||Questions and discussion||Sergio SCHWARTZMAN
|1830||Close of meeting||Joung-Liang LAN|