van der Heijde, D. M. et al. Physical function, disease activity, and health-related quality-of-life outcomes after 3 years of adalimumab treatment in patients with ankylosing spondylitis. Arthritis Res. Ther. 11, R124 (2009).

van der Heijde, D. M. et al. Assessment of radiographic progression in the spines of patients with ankylosing spondylitis treated with adalimumab for up to 2 years. Arthritis Res. Ther. 11, R127 (2009).

Long-term data on the use of adalimumab, Abbott's fully human anti-tumor necrosis factor (TNF) antibody, for ankylosing spondylitis (AS) have now been published in two papers in Arthritis Research & Therapy.

The first paper presents 3-year data from the open-label extension of the ATLAS phase III clinical trial assessing adalimumab in patients with AS (according to the modified New York AS criteria) who had failed to respond to (or who were intolerant to) treatment with at least one NSAID or DMARD. Improvements in disease activity, patient-reported physical function and health-related quality of life outcomes observed in patients receiving adalimumab during the 24-week double-blinded phase of the trial were maintained over this timeframe. “The most important finding was to see that function and spinal mobility remained improved over 3 years,” says Désirée van der Heijde from Leiden University Medical Center, who is the lead researcher on this trial.

Radiographic data from ATLAS and a Canadian study were analyzed in the second paper, which showed that radiographic progression failed to slow down in patients who received adalimumab for 2 years in comparison with patients who were naive to TNF blockade.

The authors point out that 2 years is possibly too short a timeframe for radiographic progression to be assessed in such a slowly progressing disease. They also suggest that this agent should be given earlier in the disease course. “This is already happening in practice,” says van der Heijde, “and clinical trials in patients not fulfilling the modified NY criteria, but meeting the ASAS axial SpA criteria, are underway.”