EFFECTIVENESS OF DOSE REDUCTION AND WITHDRAWAL STRATEGIES OF TNF INHIBITORS IN PSORIATIC ARTHRITIS AND AXIAL SPONDYLOARTHRITIS: LONG TERM EXTENSION OF THE DRESS-PS STUDY
Authors: Peeters A et al.
In the previously published DRESS-PS study, 122 patients (64 PsA and 58 axSpA) were randomised to a T2T strategy with (N=81) or without tapering (N=41). The proportion of patients in LDA at 12 months was 69% for the tapering and 73% for the no-tapering group: in line with the assumption that a T2T strategy including tapering does not result in a worse outcome despite a significant reduction of TNFi use. This presentation provides the data from the long term extension of the second 12 months. 114 patients were included in the extension study where tapering (according to T2T or daily practice) was allowed for all patients.
67% of patients originally allocated in the intervention group and 72% of patients originally allocated to the control group were in LDA at 24 months. 89% of patients attempted tapering during follow-up, all patients of the intervention group and 63% of the control group. Despite significant dose reductions of TNFi in the intervention group (66% versus 77%), outcome after 24 months including functioning and quality of life was comparable. The authors concluded that treat-to-target tapering was possible up to two years and yielded similar outcomes compared to usual care tapering but was able to further dose reduce TNFi.
This data suggests that treat-to-target strategies in PsA/axSpA may effectively include tapering of TNFi and result in sustained clinical and functional outcomes.