Quick Relapse After Stopping TNF Inhibitors in Peripheral Spondylitis


EULAR 2013: In a small Dutch study, most patients who stopped anti-tumor necrosis factor inhibitor therapy relapsed within a few months.

A majority of patients with peripheral spondyloarthritis (SpA) who discontinue successful therapy with anti-tumor necrosis factor-α (anti-TNF- α) agents relapse within 16 weeks, according to Dutch researchers.

Investigators at the Academic Medical Center at the University of Amsterdam followed  26 patients with low disease activity in peripheral SpA who had received 12 (n=12) or 24 weeks (n=14) of adalimumab before stopping therapy. Patients were monitored for 16 weeks and at a relapse visit after symptoms worsened.
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 (BASDAI).

More than 70% of the patients had a rapid relapse and a significant increase in disease activity parameters, with a mean time to relapse of 10 weeks, the researchers told the 2013 annual meeting of the European League Against Rheumatism (EULAR) in Madrid.

Only four patients maintained a 66 Swollen Joint Count (SJC66) of zero or an Ankylosing Spondylitis Disease Activity Score (ASDAS) of inactive disease over 16 weeks.

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