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Tumour necrosis factor (TNF) blockade is effective in axial spondyloarthritis (SpA), including both ankylosing spondylitis and non-radiographic axial SpA,1 as well as peripheral SpA, which comprises psoriatic arthritis (PsA) but also other SpA subtypes.2 It is well established that anti-TNF therapy discontinuation leads to fast relapse in almost all axial SpA patients.3–8 This study aimed to investigate if similar relapses are seen after anti-TNF therapy discontinuation in peripheral SpA.
Twenty-six patients from our randomised clinical trial with adalimumab in peripheral arthritis in non-AS, non-PsA SpA2 were included. Patients had received either 12 (n=12) or 24 weeks (n=14) of adalimumab2 before discontinuation of the anti-TNF therapy. After discontinuation, patients were followed for 16 weeks and seen for a relapse visit upon worsening of symptoms. Relapse was defined as increase of ≥1 swollen joint, or ≥2 points in patient's or physician's global assessment of disease activity or Bath Ankylosing Spondylitis Disease Activity Index. At the relapse visit, …