We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Predictors of Loss of Remission and Disease Flares in Patients with Axial Spondyloarthritis Receiving Antitumor Necrosis Factor Treatment: A Retrospective Study.
- Authors
Lubrano, Ennio; Perrotta, Fabio Massimo; Manara, Maria; D'Angelo, Salvatore; Addimanda, Olga; Ramonda, Roberta; Punzi, Leonardo; Olivieri, Ignazio; Salvarani, Carlo; Marchesoni, Antonio; Massimo Perrotta, Fabio
- Abstract
<bold>Objective: </bold>The aim of this study was to evaluate rate and predictive factors of loss of remission and disease flare in patients with axial spondyloarthritis (axSpA) receiving antitumor necrosis factor (anti-TNF) treatment.<bold>Methods: </bold>In this retrospective multicenter study, patients with axSpA, according to the Assessment of Spondyloarthritis international Society (ASAS) criteria, treated with adalimumab, etanercept, or infliximab with a minimum followup of 12 months and satisfying the ASAS partial remission criteria and/or Ankylosing Spondylitis Disease Activity Score (ASDAS) inactive disease were studied. Disease flare was defined as a Bath Ankylosing Spondylitis Disease Activity Index score > 4.5 or ASDAS score > 2.5 on at least 1 occasion.<bold>Results: </bold>One hundred seventy-four patients with axSpA were studied. After a median [interquartile range (IQR)] followup of 4 years (2-6), 37 patients (21.2%) experienced a loss of remission and 28 (16.1% of the whole study group) a disease flare. Median (IQR) duration of remission in patients who lost this status was 1 year (0.625-2). Higher median erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) values, continuous nonsteroidal antiinflammatory drug (NSAID) use, and an ASDAS-CRP ≥ 0.8 during the remission period were significantly associated with both loss of remission and disease flare. At the multivariate analysis, continuous NSAID intake (OR 4.05, 95% CI 1.4-11.74, p = 0.010) and ESR > 15 (OR 2.90, 95% CI 1.23-6.82, p = 0.015) were the only factors predictive of disease reactivation.<bold>Conclusion: </bold>In this study, loss of remission and disease flares occurred, respectively, in about 21% and 16% of the patients with axSpA who achieved a state of remission while receiving anti-TNF therapy. Residual disease activity was associated with disease reactivation.
- Subjects
ANTIRHEUMATIC agents; COMPARATIVE studies; RESEARCH methodology; MEDICAL cooperation; RESEARCH; SPONDYLOARTHROPATHIES; TUMOR necrosis factors; EVALUATION research; TREATMENT effectiveness; RETROSPECTIVE studies; SEVERITY of illness index; CHEMICAL inhibitors; DIAGNOSIS
- Publication
Journal of Rheumatology, 2016, Vol 43, Issue 8, p1541
- ISSN
0315-162X
- Publication type
journal article
- DOI
10.3899/jrheum.160363