title: Remission in ankylosing spondylitis treated with anti-TNF-α drugs: a national multicentre study.
abstract: OBJECTIVE
  The primary objective of this retrospective study was to investigate the possibility of achieving partial remission (PR) in AS patients treated with anti-TNF-α antagonists, such as adalimumab (ADA), etanercept (ETA) and infliximab (INF), in a real clinical practice setting. Predictors of PR were also evaluated.
  
  
  METHODS
  A retrospective study was conducted in patients with AS treated with ADA, ETA and INF from 2000 to 2012. Kaplan-Meier survival curves were plotted to determine the rates of PR during the treatment with anti-TNF-α drugs.
  
  
  RESULTS
  A total of 283 patients with AS were treated with ADA (18.7%), ETA (26.8%) and INF (54.4%) as first anti-TNF-α drugs, with a PR rate of 57.6%. The probability of obtaining PR with ADA, ETA or INF was not significantly different among all anti-TNF-α patients. AS patients treated with a second anti-TNF-α drug had a PR rate of 40.5%, but after switching for lack of response, the probability of obtaining PR with a second anti-TNF-α drug was significantly lower from that of the first anti-TNF-α drug (P = 0.0039). The probability of obtaining PR in patients with enthesitis (P = 0.04) or psoriasis (P = 0.0016) or low levels of CRP (P = 0.0225) was significantly lower compared with that of patients without these manifestations at baseline.
  
  
  CONCLUSIONS
  Our real-life study on PR confirmed the effectiveness of ADA, ETA or INF as first or second anti-TNF-α drugs. The presence at baseline of enthesitis or psoriasis or low CRP values yielded a lower probability of obtaining PR.
authors.affiliation: Dipartimento di Medicina Interna e Specialità Mediche - UOC di Reumatologia - Sapienza - Università di Roma, Azienda Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy. a.spadaro.reuma@virgilio.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Spadaro
authors.forename: Ennio
authors.initials: E
authors.lastname: Lubrano
authors.forename: Antonio
authors.initials: A
authors.lastname: Marchesoni
authors.forename: Salvatore
authors.initials: S
authors.lastname: D'Angelo
authors.forename: Roberta
authors.initials: R
authors.lastname: Ramonda
authors.forename: Olga
authors.initials: O
authors.lastname: Addimanda
authors.forename: Fabio Massimo
authors.initials: FM
authors.lastname: Perrotta
authors.forename: Ignazio
authors.initials: I
authors.lastname: Olivieri
authors.forename: Leonardo
authors.initials: L
authors.lastname: Punzi
authors.forename: Carlo
authors.initials: C
authors.lastname: Salvarani
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D004341:Drug Evaluation; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000069285:Infliximab; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012074:Remission Induction; D012189:Retrospective Studies; D013167:Spondylitis, Ankylosing / Q000097:blood / Q000188:drug therapy*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D015415:Biomarkers; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept
keywords: ankylosing spondylitis; anti-TNF-α drugs; remission