Magnetic resonance imaging characteristics in patients with spondyloarthritis and clinical diagnosis of heel enthesitis: post hoc analysis from the phase 3 ACHILLES trial.

OBJECTIVE: To investigate the imaging characteristics and clinically assess heel enthesitis in spondyloarthritis (SpA) by applying in a post hoc analysis the Heel Enthesitis Magnetic Resonance Imaging Scoring system (HEMRIS) in blinded and centrally-read MRI data from the ACHILLES trial (NCT02771210). METHODS: ACHILLES included patients (≥18 years) with active psoriatic arthritis or axial SpA with clinical and MRI-positive heel enthesitis refractory to standard treatment. Patients were randomized to receive subcutaneous secukinumab 150/300 mg or placebo. At week 24, patients on placebo were switched to secukinumab treatment. MRI-positive heel enthesitis was confirmed in all patients by local investigators. MRIs were performed at 3 timepoints: screening and weeks 24 and 52. In the present analysis, all MRIs were re-evaluated by 2 blinded central readers in a consensus read fashion for a priori defined MRI parameters based on HEMRIS. RESULTS: At screening, 171/204 (83.8%) of patients presented with entheseal inflammation and/or structural damage, considering both the Achilles tendon and plantar fascia. Pathologies were more evident in the Achilles tendon area compared to the plantar aponeurosis. The most frequent pathologies were intra-tendon hypersignal and retrocalcaneal bursitis. The mean total entheseal inflammation score at screening in the Achilles tendon area was 2.99 (N=204) and the mean change (standard deviation [SD]) from screening to weeks 24 and 52 was - 0.91 (1.99) and - 0.83 (2.12) in the secukinumab group vs - 0.48 (1.86) and - 0.80 (1.98) in the placebo-secukinumab group, respectively. The mean total structural damage score at screening was 1.36 (N=204) and the mean change (SD) from screening to weeks 24 and 52 was 0.00 (0.65) and - 0.06 (0.56) in the secukinumab group vs 0.08 (0.48) and 0.04 (0.75) in the placebo-secukinumab group, respectively. CONCLUSIONS: Based on the newly developed HEMRIS, entheseal inflammation and/or structural damage was confirmed in 83.3% of ACHILLES patients. Pathologies were more evident in the Achilles tendon area compared to plantar fascia, with the inflammatory parameters being more responsive with secukinumab treatment compared to placebo. The present analysis, with detailed information on individual MRI parameters, contributes to the scientific debate on heel enthesitis. TRIAL REGISTRATION: ClinicalTrials.gov NCT02771210 .

Two fold modified chitosan for enhanced adsorption of hexavalent chromium from simulated wastewater and industrial effluents.

Ionic solid (Ethylhexadecyldimethylammoniumbromide) impregnated phosphated chitosan (ISPC) was synthesized and applied for enhanced adsorption of hexavalent chromium from industrial effluent. The compound obtained was extensively characterized using instrumental techniques like FT-IR, TGA-DTA, XRD, SEM, BET and EDX. ISPC showed high adsorption capacity of 266.67mg/g in accordance with Langmuir isotherm model at pH 3.0 due to the presence of multiple sites which contribute for ion pair and electrostatic interactions with Cr(VI) species. The sorption kinetics and thermodynamic studies revealed that adsorption of Cr(VI) followed pseudo-second-order kinetics with exothermic and spontaneous behaviour. Applicability of ISPC for higher sample volumes was discerned through column studies. The real chrome plating industry effluent was effectively treated with total chromium recovery of 94%. The used ISPC was regenerated simply by dilute ammonium hydroxide treatment and tested for ten adsorption-desorption cycles with marginal decrease in adsorption efficiency.

Synergistic behaviour of ionic liquid impregnated sulphate-crosslinked chitosan towards adsorption of Cr(VI).

Aliquat-336 (an ionic liquid) impregnated sulphate-crosslinked chitosan (SCC) was prepared for escalating the adsorption of hexavalent chromium through concurrent interaction. The compound obtained was intensively characterized using Fourier transform infra red (FT-IR), X-ray diffraction (XRD), Scanning electron microscopic (SEM) and Energy dispersive X-ray (EDX) studies. Various isotherm studies have been carried out to understand the adsorption mechanism. Quantitative adsorption of Cr(VI) was observed at pH 3.0 with adsorption capacity of 250.90 mg g(-1) in accordance with Langmuir isotherm. The adsorption of Cr(VI) followed pseudo-second-order kinetics. The adsorption efficiency was found to decrease with increase in temperature due to increased randomness at interaction sites. The adsorption process was found to be exothermic and spontaneous in nature. Column studies were carried out to understand the applicability of the material for higher sample volumes. The adsorbent could be regenerated using sodium hydroxide treatment and the regenerated adsorbent had same efficiency towards adsorption of Cr(VI) as that of the original.