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Dose reduction of biological treatment in patients with axial spondyloarthritis in clinical remission: Are there any differences between patients who relapsed and to those who remained in low disease activity?

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Abstract

The aim of the study was to assess whether dose reduction of biological treatment in patients with axial spondyloarthritis in sustained remission could be effective to maintain remission or low disease activity at 1 year and to explore baseline differences between patients who remained in remission or low disease activity and patients who relapsed. This was a prospective, observational study. All consecutive patients with axial spondyloarthritis in sustained remission were included and received low doses of anti-TNF-α according to a dose reduction protocol. At 1 year, the percentage of patients in remission or low disease activity and in relapse and the differences in baseline characteristics between the two groups were calculated. Of forty-two patients, 76.2 % remained in remission or low disease activity at 1 year. A significant shorter duration of remission before dose reduction, shorter duration of biological treatment and shorter disease duration were observed in the relapse group. Most of our patients with axial spondyloarthritis remained in remission or low disease activity at 1 year after dosage reduction of biologics and shorter duration of remission, shorter duration of biological treatment and shorter disease duration discriminated the patients who relapsed.

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References

  1. Braun J, Brandt J, Listing J, Zink A, Alten R, Golder W et al (2002) Treatment of active ankylosing spondylitis with infliximab: a randomised controlled multicentre trial. Lancet 359:1187–1193

    Article  CAS  PubMed  Google Scholar 

  2. Brandt J, Khariouzov A, Listing J, Haibel H, Sörensen H, Grassnickel L et al (2003) Six-month results of a double-blind, placebo-controlled trial of etanercept treatment in patients with active ankylosing spondylitis. Arthritis Rheum 48:1667–1675

    Article  CAS  PubMed  Google Scholar 

  3. Van der Heijde D, Kivitz A, Schiff MH, Sieper J, Dijkmans BA, Braun J et al (2006) Efficacy and safety of adalimumab in patients with ankylosing spondylitis: results of a multicenter, randomized, double-blind, placebo-controlled trial. Arthritis Rheum 54:2136–2146

    Article  PubMed  Google Scholar 

  4. Sieper J, van der Heijde D, Dougados M, Mease PJ, Maksymowych WP, Brown MA et al (2013) Efficacy and safety of adalimumab in patients with non-radiographic axial spondyloarthritis: results of a randomised placebo-controlled trial (ABILITY-1). Ann Rheum Dis 72:815–822

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  5. Navarro-Compán V, Moreira V, Ariza-Ariza R, Hernández-Cruz B, Vargas-Lebrón C, Navarro-Sarabia F (2011) Low doses of etanercept can be effective in ankylosing spondylitis patients who achieve remission of the disease. Clin Rheumatol 30:993–996

    Article  PubMed  Google Scholar 

  6. Paccou J, Baclé-Boutry MA, Solau-Gervais E, Bele-Philippe P, Flipo RM (2012) Dosage adjustment of anti-tumor necrosis factor-α inhibitor in ankylosing spondylitis is effective in maintaining remission in clinical practice. J Rheumatol 39:1418–1423

    Article  CAS  PubMed  Google Scholar 

  7. De Stefano R, Frati E, De Quattro D, Menza J, Manganelli S (2014) Low doses of etanercept can be effective to maintain remission in ankylosing spondylitis patients. Clin Rheumatol 33:707–711

    PubMed  Google Scholar 

  8. Cantini F, Niccoli F, Cassarà E, Kaloudi O, Nannini C (2013) Duration of remission after halving of the etanercept dose in patients with ankylosing spondylitis: a randomized, prospective, long-term, follow-up study. Biologics 7:1–6

    PubMed Central  CAS  PubMed  Google Scholar 

  9. Jois RN, Leeder J, Gibb A, Gaffney K, Macgregor A, Somerville M (2006) Low dose infliximab treatment for ankylosing spondylitis-clinically and cost-effective. Rheumatology 45:1566–1569

    Article  CAS  PubMed  Google Scholar 

  10. Keeling S, Oswald A, Russell AS, Maksymowych WP (2006) Prospective observational analysis of the efficacy and safety of low-dose (3 mg/kg) infliximab in ankylosing spondylitis: 4-year followup. J Rheumatol 33:558–561

    CAS  PubMed  Google Scholar 

  11. Inman RD, Maskymowych WP (2010) A double-blind, placebo-controlled trial of low dose infliximab in ankylosing spondylitis. J Rheumatol 37:1203–1210

    Article  PubMed  Google Scholar 

  12. Rudwaleit M, van der Heijde D, Landewe R, Akkoc N, Brandt J, Chou CT et al (2009) The development of assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis 68:777–783

    Article  CAS  PubMed  Google Scholar 

  13. Van der Linden S, Valkenburg HA, Cats A (1984) Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the spondylitis New York criteria. Arthritis Rheum 27:361–368

    Article  PubMed  Google Scholar 

  14. Dougados M, Béhier JM, Jolchine I, Calin A, van der Heijde D, Olivieri I (2001) Efficacy of celecoxib, a cyclooxygenase 2-specific inhibitor, in the treatment of ankylosing spondylitis: a 6-week controlled study with comparison against placebo and against a conventional nonsteroidal antiinflammatory drug. Arthritis Rheum 44:180–185

    Article  CAS  PubMed  Google Scholar 

  15. Poddubnyy D, Haibel H, Listing J, Märker-Hermann E, Zeidler H, Braun J et al (2012) Baseline radiographic damage, elevated acute-phase reactant levels, and cigarette smoking status predict spinal radiographic progression in early axial Spondylarthritis. Arthritis Rheum 64:1388–1398

    Article  PubMed  Google Scholar 

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There is no any financial support or other benefits from commercial sources for the work reported on in the manuscript.

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None of the authors have no conflicts of interest to declare.

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Correspondence to Miriam Almirall.

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Almirall, M., Salman-Monte, T.C., Lisbona, M.P. et al. Dose reduction of biological treatment in patients with axial spondyloarthritis in clinical remission: Are there any differences between patients who relapsed and to those who remained in low disease activity?. Rheumatol Int 35, 1565–1568 (2015). https://doi.org/10.1007/s00296-015-3288-z

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  • DOI: https://doi.org/10.1007/s00296-015-3288-z

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