title: Persistent clinical efficacy and safety of infliximab in ankylosing spondylitis after 8 years--early clinical response predicts long-term outcome.
abstract: OBJECTIVE
  To report for the first time on the efficacy and safety of anti-TNF therapy after 8 years of follow-up in patients with active AS, and analyse possible short-term predictors for long-term clinical outcomes.
  
  
  METHODS
  In this open-label extension of a randomized controlled trial, proportions of the initially included 69 patients with active AS were treated with infliximab 5 mg/kg i.v./6 weeks for 8 years. The last report was published after 5 years. All analyses were based on completers.
  
  
  RESULTS
  Overall, 33 (48%) patients completed 8 years. Their mean (s.d.) BASDAI [2.6 (1.9)], BASFI [3.3 (2.6)] and BASMI [2.7 (2.4)] remained low at Year 8. At the end of Year 8, most patients were either in partial remission (n = 8, 24%) or had low disease activity (BASDAI < 3; n = 21, 64%). No new serious adverse events occurred within the past 3 years. Adverse events were the most frequent reason for dropout (56%). There were no differences between completers and dropouts at baseline, but the latter had higher BASFI values at dropout. No baseline parameter was associated with good long-term response to infliximab, but lower BASDAI levels after 12 weeks were predictive of a higher probability of partial remission [odds ratio (OR) 2.9, 95% CI 1.3, 6.3, P = 0.007], low disease activity (OR 1.7, 95% CI 1.2, 2.3, P = 0.005) or remaining on treatment (OR 0.79, 95% CI 0.61, 1.01, P = 0.06) after 8 years.
  
  
  CONCLUSIONS
  Almost half of the initially treated patients remained on anti-TNF therapy for 8 years, and almost 90% were in partial remission or had low disease activity. Short-term response (low BASDAI at 3 months) is predictive of outcome after 8 years. Infliximab therapy was safe over 8 years.
authors.affiliation: Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Landgrafenstr. 15, 44652 Herne, Germany. j.braun@rheumazentrum-ruhrgebiet.de.
authors.forename: Xenofon
authors.initials: X
authors.lastname: Baraliakos
authors.forename: Joachim
authors.initials: J
authors.lastname: Listing
authors.forename: Claudia
authors.initials: C
authors.lastname: Fritz
authors.forename: Hildrun
authors.initials: H
authors.lastname: Haibel
authors.forename: Rieke
authors.initials: R
authors.lastname: Alten
authors.forename: Gerd-Rüdiger
authors.initials: GR
authors.lastname: Burmester
authors.forename: Andreas
authors.initials: A
authors.lastname: Krause
authors.forename: Stefan
authors.initials: S
authors.lastname: Schewe
authors.forename: Matthias
authors.initials: M
authors.lastname: Schneider
authors.forename: Helmut
authors.initials: H
authors.lastname: Sörensen
authors.forename: Reinhold
authors.initials: R
authors.lastname: Schmidt
authors.forename: Joachim
authors.initials: J
authors.lastname: Sieper
authors.forename: Juergen
authors.initials: J
authors.lastname: Braun
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000069285:Infliximab; D008297:Male; D010352:Patient Dropouts; D016032:Randomized Controlled Trials as Topic; D012074:Remission Induction; D013167:Spondylitis, Ankylosing / Q000188:drug therapy*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab