title: Frequency and duration of drug-free remission after 1 year of treatment with etanercept versus sulfasalazine in early axial spondyloarthritis: 2 year data of the ESTHER trial.
abstract: OBJECTIVE
  The aims of this study were (1) to assess the frequency and duration of drug-free remission and efficacy of etanercept (ETA) treatment after flare in patients with early active axial spondyloarthritis who were treated with ETA (n=40) versus sulfasalazine (SSZ, n=36) for 48 weeks and (2) to analyse the efficacy of ETA treatment in patients in year 2 who did not reach remission at week 48.
  
  
  METHODS
  At week 48, patients who reached study remission (Assessment of Spondyloarthritis international Society (ASAS) plus MRI remission) were followed up without active treatment up to 1 year. In case of a flare, patients were treated with ETA for another year. All patients who were not in ASAS plus MRI remission at week 48 were treated with ETA in year 2.
  
  
  RESULTS
  ASAS plus MRI remission at week 48 was reached significantly more often in ETA-treated compared to SSZ-treated patients (33% vs 11%, p=0.03). However, the flare rate was not different between these two groups: 69% in the ETA group versus 75% in the SSZ group. Only 8% of patients initially treated with ETA versus 3% of those initially treated with SSZ reached permanent drug-free remission (not significant). After treatment with ETA over 1 year, patients with flare showed an improvement in all clinical and imaging variables.
  
  
  CONCLUSIONS
  Patients with axial spondyloarthritis treated with ETA over 1 year did not reach drug-free remission in a higher percentage compared to patients from a control group treated with SSZ.
authors.affiliation: Department of Rheumatology, Charité Medical University, Campus Benjamin-Franklin, Berlin, Germany.
authors.forename: In-Ho
authors.initials: IH
authors.lastname: Song
authors.forename: Christian E
authors.initials: CE
authors.lastname: Althoff
authors.forename: Hildrun
authors.initials: H
authors.lastname: Haibel
authors.forename: Kay-Geert A
authors.initials: KG
authors.lastname: Hermann
authors.forename: Denis
authors.initials: D
authors.lastname: Poddubnyy
authors.forename: Joachim
authors.initials: J
authors.lastname: Listing
authors.forename: Anja
authors.initials: A
authors.lastname: Weiß
authors.forename: Svetlana
authors.initials: S
authors.lastname: Djacenko
authors.forename: Gerd R
authors.initials: GR
authors.lastname: Burmester
authors.forename: Martin
authors.initials: M
authors.lastname: Bohl-Bühler
authors.forename: Bruce
authors.initials: B
authors.lastname: Freundlich
authors.forename: Martin
authors.initials: M
authors.lastname: Rudwaleit
authors.forename: Joachim
authors.initials: J
authors.lastname: Sieper
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D057915:Drug Substitution; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D012008:Recurrence; D012074:Remission Induction; D013131:Spine / Q000473:pathology; D013167:Spondylitis, Ankylosing / Q000188:drug therapy* / Q000473:pathology; D012460:Sulfasalazine / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D012460:Sulfasalazine; D000068800:Etanercept