Background The effectiveness of TNF blockers in treating axial Spondyloarthritis patients is well know, but we don’t know most appropriate dosage for treatment of patients in persistent clinical remission.
Objectives Our objective is to assess the clinical activity at 3 and 6 months in patients with axial Spondyloarthritis in persistent remission who received low dosages of biological therapy.
Methods We performed a observational study with patients of our department with axial Spondyloarthritis including Ankylosing Spondylitis who received low dosages of TNF blockers until September 2012 by persistent remission (BASDAI≤2, absence of arthritis and enthesitis and normality of CRP values) for a minimum of 6 months without NSAIDs consume. Data analysed were: demographic characteristics, duration of clinical remission, diagnosis and disease duration, type and duration of biological agent used and at 3 and 6 months: percentage of patients who remained in remission (BASDAI≤2), percentage who had low disease activity (BASDAI between 2 and 4 units) and percentage who relapsed (BASDAI≥4) and required the previous dose of biological treatment.
Results We included 40 patients (75% man) with a mean age of 43,7+/- 13 years and a mean time of remission of 28,7 +/- 18,5 months. The diagnoses were: 33 Ankylosing Spondylitis, 5 non-radiographic axial Spondyloarthritis and 2 Spondyloarthritis associated with bowel inflammatory disease. They had a mean duration of disease of 8,6+/- 6,1 years and 75% of patients had HLAB27 positive. 7 patients received Etanercept, 7 Infliximab and 26 Adalimumab and a mean duration of current biological therapy was 41,9 +/- 23,9 months. Used low dosages was 50 mg every 10 days or 25 mg every week for Etanercept, 3mg/kg every 8 weeks for Infliximab and 40 mg every 3 weeks for Adalimumab. All 40 patients had a minimum follow-up of 3 months after dosage reduction. At 3 months 85% of patients remained in remission, 10% had low disease activity and 5% relapsed (2). 24 patients were followed for 6 months after dosage reduction. At 6 months 71% remained in clinical remission, 12,5% had low disease activity and 16,5% relapsed (4), 2 at 3 months and 2 at 6 months.
Conclusions Most of our patients with axial Spondylarthritis remained in clinical remission at 3 and 6 months after after dosage reduction of TNF blockers. Only a small percentage of the patients relapsed and required the previous dosage of biological treatment.
Disclosure of Interest None Declared
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