Biologic DMARDs are a cornerstone treatment for severe axial spondyloarthritis. Although indications for treatment initiation are well codified, the timing and modalities for tapering remain unclear, despite medical and economic concerns. Encouraging data about treatment tapering are emerging that might guide future management strategies.
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References
Sieper, J. & Poddubnyy, D. Axial spondyloarthritis. Lancet 390, 73–84 (2017).
Smolen, J. S. et al. Treating spondyloarthritis, including ankylosing spondylitis and psoriatic arthritis, to target: recommendations of an international task force. Ann. Rheum. Dis. 73, 6–16 (2014).
Gratacós, J. et al. Non-inferiority of dose reduction versus standard dosing of TNF-inhibitors in axial spondyloarthritis. Arthritis Res. Ther. 21, 11 (2019).
Van Der Heijde, D. et al. 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. Ann. Rheum. Dis. 76, 978–991 (2017).
Rudwaleit, M. et al. The development of Assessment of SpondyloArthritis International Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann. Rheum. Dis. 68, 777–783 (2009).
Navarro-Compán, V. et al. Anti-TNF discontinuation and tapering strategies in patients with axial spondyloarthritis: a systematic literature review. Rheumatology (Oxford) 55, 1188–1194 (2016).
Li, K. et al. Full dose, half dose, or discontinuation of etanercept biosimilar in early axial spondyloarthritis patients: a real-world study in China. Arch. Med. Sci. https://doi.org/10.5114/aoms.2018.76141 (2018).
Park, J. W. et al. Impact of dose tapering of tumor necrosis factor inhibitor on radiographic progression in ankylosing spondylitis. PLOS ONE 11, e0168958 (2016).
Yates, M. et al. Is Etanercept 25 mg once weekly as effective as 50 mg at maintaining response in patients with ankylosing spondylitis? A randomized control trial. J. Rheumatol. 42, 1177–1185 (2015).
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Ziade, N.R., Baraliakos, X. Tapering bDMARDs in axial SpA — what is the current evidence?. Nat Rev Rheumatol 15, 322–324 (2019). https://doi.org/10.1038/s41584-019-0201-2
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DOI: https://doi.org/10.1038/s41584-019-0201-2
