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Fast relapse upon discontinuation of tumour necrosis factor blocking therapy in patients with peripheral spondyloarthritis
  1. Jacqueline E Paramarta,
  2. Tanja F Heijda,
  3. Dominique L Baeten
  1. Department of Clinical Immunology and Rheumatology, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands
  1. Correspondence to Professor Dominique L Baeten, Department of Clinical Immunology and Rheumatology, Academic Medical Center/University of Amsterdam, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands; d.l.baeten{at}

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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, …

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  • Contributors All authors were involved in drafting the article or revising it critically for important intellectual content, and all authors approved the final version to be published. Study conception and design: JEP and DLB. Data acquisition: JEP and TFH. Analysis and interpretation of the data: JEP and DLB.

  • Funding None.

  • Competing interests None.

  • Patient consent All patients gave written informed consent.

  • Data sharing statement Data of our research article are available upon request. Additional data of this cohort are expected to be published in the future.

  • Ethics approval Approved by the Medical Ethics Committee of the Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands.

  • Provenance and peer review Not commissioned; externally peer reviewed.