Spinal Radiographic Progression and Predictors of Progression in Patients With Radiographic Axial Spondyloarthritis Receiving Ixekizumab Over 2 Years

Objective To evaluate the long-term effect of ixekizumab on radiographic changes in the spine in patients with radiographic axial spondyloarthritis (r-axSpA) by measuring change from baseline through 2 years in modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) and to identify potential predictors of progression. Methods This study evaluates patients from COAST-V (NCT02696785, bDMARD-naive) and COAST-W (NCT02696798, TNFi-experienced) who had mSASSS data at baseline in the originating studies and 108 weeks after baseline in the extension study COAST-Y (NCT03129100). We examined the proportion of patients who did not have spinal radiographic progression through 2 years (108 weeks) of treatment with ixekizumab (80 mg every 2 or 4 weeks) and the change from baseline to year 2 in mSASSS. Potential predictors of spinal radiographic progression were also evaluated. Results Among patients with evaluable radiographs who were originally assigned to ixekizumab (N=230), mean (SD) change in mSASSS from baseline at year 2 was 0.3 (1.8). The proportion of non-progressors over 2 years was 89.6% if defined as mSASSS change from baseline <2 and 75.7% if defined as mSASSS change from baseline ≤0. Predictors of structural progression at year 2 (mSASSS change >0) were age ≥40, baseline syndesmophytes, HLA-B27 positivity and male gender. Week 52 inflammation in SPARCC spine was also a predictor of radiographic progression at year 2 in patients with MRI-data in COAST-V (N=109). Conclusion The majority of patients with r-axSpA receiving ixekizumab had no radiographic progression in the spine through 2 years of treatment. Predictors were generally consistent with previous studies.

The complexities of measuring change in prisoners with sexual offence histories

Assessing change in incarcerated sexual offenders is critical to release decision-making and risk management. This study measured change in a group of treatment completers from a custody-based treatment program. Change was determined through comparison of pre- and post-treatment psychological testing and structured therapist assessment. Data were analysed at the group and individual levels. Multiple complexities were evident when examining the psychometric test results; many participants were considered ‘functional’ (within the normal range) according to extant test norms prior to treatment, and many who were regarded as ‘dysfunctional’ pre-treatment remained in this range post-treatment. Tests measuring constructs from the same risk factor domain often produced inconsistent results and, for most participants, change was only evident on some tests. Psychometric assessment results and therapist ratings were associated. These results highlight the complexities inherent in the evaluation of change. Clinical implications for the measurement of change and test selection are discussed.

Grand Strategy and the Challenge of Change

Why do some states persist with grand strategies that have become excessively burdensome? Generations of great powers have become overstretched by squandering resources in areas of peripheral importance, instead of cutting their losses and focusing on core interests. This chapter explores the incentives, barriers, and enablers of grand-strategic change. It first offers a definition of grand strategy, before outlining a two-tiered framework for measuring change. The chapter then examines the structural incentives for altering a state’ grand strategy, as well as the psychological, cultural, organizational, and domestic impediments. Short of a catastrophic strategic shock, grand-strategic change is rare. It is possible, however, given the right systemic conditions, as well as the presence of change agents and a viable alternative to the status quo.

Dangers of including outcome at baseline as a covariate in latent change score models

Latent change score modelling is a version of structural equation modelling for measuring change between measurements. It seems quite common to regress change on the initial value included in the calculation of the change score (i.e. ΔY (= Y2 – Y1) is regressed on Y1). However, similarly as in simpler regression analyses, this procedure may make findings susceptible to the influence of regression to the mean. This suspicion was verified in the present simulations. An empirical application, including re-analyses of previously published data, indicated that previously claimed reciprocal promoting effects of vocabulary and matrix reasoning on each other’s longitudinal development may actually be due to regression to the mean. Researchers are recommended not to regress change on the initial value included in the calculation of the change score when employing latent change score modelling, or at least to verify findings with analyses omitting this parameter.

Analyzing development patterns in research networks and technology

The present paper analyzes development patterns in research networks and technology as well as their co-evolution by the example of the currently highly transformative German automotive industry. We therefore introduce a consistent network-based approach for measuring change in research networks and the technological composition of patents. Our results show that the applied method is particularly useful for identifying structural similarities and main structural changes in research and patent networks. Further, the investigation of the co-evolutionary processes indicates that, regarding the German automotive industry, changes in technology lead to structural changes in the research network.