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The concept of axial spondyloarthritis. Lessons from the INFAST study
  1. Henning Zeidler
  1. Correspondence to Professor Henning Zeidler, Emeritus, Hannover Medical School, Hannover, Germany, Wolfsburger Damm 26c, Hannover 30625, Germany; zeidler.henning{at}mh-hannover.de

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Sieper et al1 evaluated whether combination therapy with infliximab (IFX) and naproxen (NPX) was superior to treatment with NPX alone in patients who had active moderate-to-severe early (disease duration under 3 years) active axial spondyloarthritis (SpA) and who were naive to non-steroidal anti-inflammatory drugs (NSAIDs) or had only been treated with a submaximal dose of NSAIDs. This study is the first investigation of the potential benefits of early tumour necrosis factor (TNF) antagonist treatment in active axial SpA patients who are not yet refractory to NSAID therapy. Additionally, this represents the first randomised controlled clinical trial to use the imaging portion of the Assessment of SpondyloArthritis International Society criteria for axial SpA with active inflammation of the sacroiliac joints on MRI at baseline. Most importantly, …

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