Do Fatty Lesions Explain the Effect of Inflammation on New Syndesmophytes in Patients with Radiographic Axial Spondyloarthritis? Results From the SIAS Cohort and ASSERT Trial

This study concluded that, in r-axSpA, vertebral corner inflammation may lead to syndesmophyte formation but in a minority of cases via visible fat deposition. Here, investigators aimed to determine how much of the effect of vertebral corner inflammation on the development of syndesmophytes is explained by vertebral corner fat deposition.

However, since only a small part of the effect of inflammation on syndesmophyte formation is explained by fatty lesions, getting more insight into how inflammation leads to syndesmophytes should be the priority. These results suggest caution in using fatty lesions as surrogate markers for structural damage. Indeed, intervening on the suppression of inflammation seems to be a more promising route to prevent syndesmophyte formation.