FEASIBILITY OF PROGRESSIVE ANTI-TNF TAPERING IN AXIAL SPONDYLOARTHRITIS PATIENTS IN LOW DISEASE ACTIVITY: RESULTS FROM THE MULTICENTER NON-INFERIORITY PROSPECTIVE RANDOMIZED CONTROLLED TRIAL SPACING
Authors: C. Lukas et al.
In RA there is good evidence that therapy with biologic DMARD can be tapered and discontinued once patients are in stable remission. There is less evidence in axSpA for successful bDMARD tapering. The authors report a randomized controlled trial with 398 axSpA patients on TNFi therapy randomized to continuation (unchanged group) or stepwise tapering of the TNFi by interval prolongation (spacing group). They found that the proportion of patients in low disease activity (BASDAI <4) at 12 months was 88% in the spacing group vs 91.5% in the unchanged group. The non-inferiority of the spacing was demonstrated.
This study confirms that dose reduction of TNFi treatment in axSpA with maintenance of disease control is possible. It has, however, to be considered that although the patients in the spacing group reduced the dose, more than 80% of the patients were still on TNFi treatment at 12 months.