Early Response to Adalimumab Predicts Long-Term Ankylosing Spondylitis Remission

The effectiveness and safety of adalimumab in patients with active ankylosing spondylitis (AS) were maintained through 5 years in a study that was reported recently in Annals of the Rheumatic Diseases. About half of the patients experienced sustained remission at any time during the study. Early remission was the best predictor of long-term and sustained remission.

Sieper and colleagues at University Clinic Benjamin Franklin in Berlin conducted a 24-week randomized controlled trial, followed by an open-label extension, in which they monitored patients with active AS for up to 5 years. They evaluated disease activity and clinical improvement with Assessment in SpondyloArthritis international Society (ASAS) responses, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and the Ankylosing Spondylitis Disease Activity Score (ASDAS). Kaplan-Meier analysis was used to identify patients who had sustained ASAS partial remission (PR) or ASDAS inactive disease (ID) for 3 or more consecutive visits spanning 6 months or longer.

Among the patients who received adalimumab for 5 years, 70%, 77%, 51%, and 61% achieved ASAS 40, BASDAI 50, ASAS PR, and ASDAS ID, respectively. Of the adalimumab-treated patients, 45% and 55% achieved sustained ASAS PR and ASDAS ID, respectively, at any time during the study. The strongest predictor of remission at years 1 and 5 and of sustained remission was achieving remission at 12 weeks of treatment.