Chamaida Plasencia1,2,3,4,5, E. Kneepkens, Gertjan Wolbink, C. Krieckaert, Samina A. Turk, Victoria Navarro‐Compán, M. l’Ami, Michael T. Nurmohamed, Irene van der Horst‐Bruinsma, Teresa Jurado‐Guerrero, Cristina Diego, Gema Bonilla, Alejandro Villalba, Diana Peiteado, Laura Nuño, Desirée van der Kleij, Theo Rispens, E. Martín‐Mola, Alejandro Balsa, Dora Pascual‐Salcedo
1Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Academic Medical Centre, University of Amsterdam
2Department of Rheumatology, VU University Medical Centre
3From the La Paz University Hospital, and the Rheumatology Department, La Paz University Hospital-Idipaz, Madrid, Spain
4Jan van Breemen Research Institute | Reade, Amsterdam, The Netherlands
5Sanquin Diagnostic Services
Tóm tắt
Objective.To compare clinical outcomes, incidence of flares, and administered drug reduction between patients with spondyloarthritis (SpA) under TNF inhibitor (TNFi) tapering strategy with patients receiving a standard regimen.Methods.In this retrospective study, 74 patients with SpA from Spain on tapering strategy (tapering group; TG) were compared with 43 patients from the Netherlands receiving a standard regimen (control group; CG). The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was measured at visit 0 (prior to starting the TNFi), visit 1 (prior to starting tapering strategy in TG and at least 6 months with BASDAI < 4 after starting the TNFi in the TG and CG), visit 2 (6 mos after visit 1), visit 3 (1 year after visit 1), and visit 4 (the last visit available after visit 1).Results.An overall reduction of the administered drug was seen at visit 4 in the TG [dose reduction of 22% for infliximab (IFX) and an interval elongation of 28.7% for IFX, 45.2% for adalimumab, and 51.5% for etanercept] without significant differences in the BASDAI between the groups at visit 4 (2.15 ± 1.55 in TG vs 2.11 ± 1.31 in CG, p = 0.883). The number of patients with flares was similar in both groups [22/74 (30%) in the TG vs 8/43 (19%) in the CG, p = 0.184].Conclusion.The tapering strategy in SpA results in an important reduction of the drug administered, and the disease control remains similar to that of the patients with SpA receiving the standard regimen.
