Dose reduction of biological treatment in patients with axial spondyloarthritis in clinical remission: Are there any differences between patients who relapsed and to those who remained in low disease activity?

The aim of the study was to assess whether dose reduction of biological treatment in patients with axial spondyloarthritis in sustained remission could be effective to maintain remission or low disease activity at 1 year and to explore baseline differences between patients who remained in remission or low disease activity and patients who relapsed. This was a prospective, observational study. All consecutive patients with axial spondyloarthritis in sustained remission were included and received low doses of anti-TNF-α according to a dose reduction protocol. At 1 year, the percentage of patients in remission or low disease activity and in relapse and the differences in baseline characteristics between the two groups were calculated. Of forty-two patients, 76.2 % remained in remission or low disease activity at 1 year. A significant shorter duration of remission before dose reduction, shorter duration of biological treatment and shorter disease duration were observed in the relapse group. Most of our patients with axial spondyloarthritis remained in remission or low disease activity at 1 year after dosage reduction of biologics and shorter duration of remission, shorter duration of biological treatment and shorter disease duration discriminated the patients who relapsed.