Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Low Doses of Etanercept Can Be Effective in Ankylosing Spondylitis Patients Who Achieve Remission of the Disease.

Navarro Compan,  Victoria, Ariza Ariza,  Rafael, Vargas Lebron,  Carmen, Hernandez Cruz,  Blanca, Moreira Navarrete,  Virginia, Navarro Sarabia,  Federico

Background:

There is no evidence other than symptoms control to maintain the antiTNF therapy in patients with ankylosing spondylitis (AS). In this regard, low dose regimens could be considered in patients whose disease is clinically controlled. Moreover, the economic implications of this strategy can be important. However, although dose reduction can be common in clinical practice, the available data about it are scarce.

Objective:

to explore the effectiveness of low dose of etanercept (ETN) in patients with ankylosing spondylitis (AS) who achieves a good control of their disease in daily clinical practice.

Methods:

case series of AS patients treated with ETN. According to the judgment of the treating rheumatologist and patient's preferences, a dose reduction was done in those patients who achieved a good control of their disease defined by BASDAI < 5 and C-reactive protein normal values. Descriptive statistics were calculated with mean, mode, median, ranges percents and lower and upper quartiles.

Results:

51 AS patients treated with ETN were identified and 16 of them (32%) were on dose reduction regimen.]

GroupPatients with low doses of Etanercept*All
 n=16, 32%n=51, 100%
Male n, %14 (94%)45 (91%)
HLA-B27 + n, %14 (87%)43 (84%)
Peripheral arthritis3 (19%)36 (71%)
Uveitis n, %5 (31%)41 (80%)
Sacroilitis n, %4 (25%) II12 (24%) II
 10 (62.5%) III20 (39%) III
 2 (12.5%) IV19 (37%) III
Previous DMARD treatment n, %6 (31%)34 (67%)
 Median (range)Median (range)
Age, years42.5 (30.5–57)44 (32.53)
Disease duration, years8 (3.5–14.7)10 (6.5–18)
BASDAI5.8 (4.5–7.7)6.2 (4.7–7.9)
BASFI5.9 (4.2–6.9)6.5 (5–8.1)
ESR34 (16–72)29 (14–72)
CRP (mg/L)17.9 (9.1–33.0)18 (10–39)
PGA55 (47–84)62 (50–87)

Several regimens of dose reduction were used. Mean time receiving ETN before adjusting the dose was 17 ± 12 months. Mean follow up after dose change was 2 1±21 months. At this point all the patients in whom dose reduction was done remained in the low dose regimen. Median BASDAI (range) at starting the low dose regimen and 6 months later were 1.6 (0.9–2.4), and 1.4 (0.3–3.2), respectively. Median CRP values (range) at starting the low dose regimen and 6 months later were 1mg/l (0.1–2.8), and 1.3 mg/l (0.3–4.1), respectively. Other disease-related variables also remained unchanged. Patients with follow up at 12 and 24 months and longer remained in clinical remission with BASDAI values <2 and normal CRP values.

Conclusions:

our data suggest that AS patients in clinical remission can use low doses of ETN without increasing disease activity. So, it can be a promising strategy but additional studies are needed to prove it.

To cite this abstract, please use the following information:
Navarro Compan, Victoria, Ariza Ariza, Rafael, Vargas Lebron, Carmen, Hernandez Cruz, Blanca, Moreira Navarrete, Virginia, Navarro Sarabia, Federico; Low Doses of Etanercept Can Be Effective in Ankylosing Spondylitis Patients Who Achieve Remission of the Disease. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1944
DOI: 10.1002/art.29709

Abstract Supplement

Meeting Menu

2010 ACR/ARHP