title: Anti-TNF-induced remission in very early peripheral spondyloarthritis: the CRESPA study.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of golimumab to induce clinical remission in patients with very early, active peripheral spondyloarthritis (pSpA).
  
  
  METHODS
  Clinical REmission in peripheral SPondyloArthritis is a monocentric study of golimumab treatment in patients with pSpA. All patients fulfilled the Assessment of SpondyloArthritis international Society classification criteria for pSpA, with a symptom duration ≤12 weeks. Patients were randomised 2:1 to receive golimumab 50 mg every 4 weeks or matching placebo for 24 weeks. The primary end point was the percentage of patients achieving clinical remission at week 24, defined as absence of arthritis, enthesitis and dactylitis. Secondary end points included joint and enthesis counts, patient-reported outcomes, erythrocyte sedimentation rate and C reactive protein. From week 12, non-responders were allowed to receive rescue medication with golimumab. Adverse events were recorded.
  
  
  RESULTS
  60 patients were randomised with similar baseline characteristics. At week 24, a significantly higher percentage of patients receiving golimumab achieved clinical remission compared with placebo (75% (30/40) vs 20% (4/20); p<0.001). At week 12, similar results were observed (70% (28/40) vs 15% (3/20); p<0.001). All secondary end points were met at week 24. Rescue medication was necessary in 50% in the placebo group opposed to only 10% in the golimumab arm. Rates of adverse events were low and similar in both groups.
  
  
  CONCLUSIONS
  Markedly high remission induction rates were noted with golimumab in very early pSpA. Of interest, in placebo-treated patients, very low spontaneous remission rates were observed.
  
  
  BACKGROUND
  NCT01426815; Results.
authors.affiliation: Department of Rheumatology, Ghent University Hospital, Ghent, Belgium.
authors.forename: Philippe
authors.initials: P
authors.lastname: Carron
authors.affiliation: Department of Rheumatology, Ghent University Hospital, Ghent, Belgium.|VIB Inflammation Research Center, Ghent University, Ghent, Belgium.
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Varkas
authors.affiliation: Department of Rheumatology, Ghent University Hospital, Ghent, Belgium.|VIB Inflammation Research Center, Ghent University, Ghent, Belgium.
authors.forename: Heleen
authors.initials: H
authors.lastname: Cypers
authors.affiliation: Department of Rheumatology, Ghent University Hospital, Ghent, Belgium.
authors.forename: Liesbet
authors.initials: L
authors.lastname: Van Praet
authors.affiliation: Department of Rheumatology, Ghent University Hospital, Ghent, Belgium.|VIB Inflammation Research Center, Ghent University, Ghent, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Elewaut
authors.affiliation: Department of Rheumatology, Ghent University Hospital, Ghent, Belgium.
authors.forename: Filip
authors.initials: F
authors.lastname: Van den Bosch
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000276:immunology; D004311:Double-Blind Method; D061345:Early Medical Intervention; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D012074:Remission Induction; D012720:Severity of Illness Index; D025242:Spondylarthropathies / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; C529000:golimumab
keywords: Anti-TNF; Psoriatic Arthritis; Spondyloarthritis