Withdrawal of infliximab therapy in ankylosing spondylitis in persistent clinical remission, results from the REMINEA study
Moreno Martínez-Losa, Mireia (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Gratacós, Jordi (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Torrente-Segarra, Vicenç (Hospital Comarcal Alt Penedès)
Sanmartí, Raimon (Hospital Clínic i Provincial de Barcelona)
Morlà, Rosa (Hospital del Vendrell)
Pontes García, Caridad (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Llop, Maria (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Juanola, Xavier (Institut d'Investigació Biomèdica de Bellvitge)
Rodriguez-De-La-Serna, Arturo (Institut d'Investigació Biomèdica Sant Pau)
Hernandez, Victoria
Riera, Elena (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ortiz, Vera (Hospital General de Granollers)
Clavaguera, Teresa (Hospital de Palamós)
Reyner, Patricia (Hospital Universitari de Girona Doctor Josep Trueta)
Sala, Miquel (Hospital Figueres)
Sellas, Agustí (Hospital Universitari Vall d'Hebron)
Pitarch, Concepció (Hospital Esperit Sant)
Reina, Delia (Hospital Sant Camil)
Blanco, Jordi (Hospital Sant Jaume de Calella)
Centelles, Montse (Consorci Sanitari del Maresme)
Figuls, Ramon (Hospital Dos de Maig (Barcelona, Catalunya))
Gelman, Mario (Hospital Sant Joan de Déu (Manresa))
Arasa, Xavier (Hospital de Tortosa Verge de la Cinta)
Bonet Llorach, Maria (Hospital Comarcal d'Alt Penedès)
Ciria, Manel (Hospital La Seu d'Urgell)
Universitat Autònoma de Barcelona

Date:	2019
Abstract:	Background: Recent data suggest that anti-TNF doses can be reduced in ankylosing spondylitis (AS) patients. Some authors even propose withdrawing treatment in patients in clinical remission; however, at present there is no evidence to support this. Objective: To assess how long AS patients with persistent clinical remission remained free of flares after anti-TNF withdrawal and to evaluate the effects of treatment reintroduction. We also analyze the characteristics of patients who did not present clinical relapse. Methods: Multicenter, prospective, observational study of a cohort of patients with active AS who had received infliximab as a first anti-TNF treatment and who presented persistent remission (more than 6 months). We recorded at baseline and every 6-8 weeks over the 12-month period the age, gender, disease duration, peripheral arthritis or enthesitis, HLA-B27 status, BASDAI, CRP, ESR, BASFI, and three visual analogue scales, spine global pain, spinal night time pain, and patient's global assessment. Results: Thirty-six out of 107 patients (34%) presented persistent remission and were included in our study. After treatment withdrawal, 21 of these 36 patients (58%) presented clinical relapse during follow-up. Infliximab therapy was reintroduced and only 52% achieved clinical remission, as they had before the discontinuation of infliximab; in an additional 10%, reintroduction of infliximab was ineffective, obliging us to change the anti-TNF therapy. No clinical or biological factors were associated with the occurrence of relapse during the follow-up. Conclusions: Two thirds of patients in clinical remission presented clinical relapse shortly after infliximab withdrawal. Although the reintroduction of infliximab treatment was safe, half of the patients did not present the same clinical response that they had achieved prior to treatment withdrawal.
Note:	Altres ajuts: This work is conducted under the umbrella of the Rheumatology Society of Catalonia and supported by Merck Research Laboratories.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Ankylosing spondylitis ; Anti-TNF therapy ; Disease activity ; Treatment withdrawal
Published in:	Arthritis research & therapy, Vol. 21 Núm. 1 (may 2019) , p. 88, ISSN 1478-6362

DOI: 10.1186/s13075-019-1873-3
PMID: 30953541

6 p, 832.7 KB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Parc Taulí Research and Innovation Institute (I3PT
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles