Withdrawal of biologic therapy in axial spondyloarthritis: the experience in established disease.

Treatment of patients suffering from active ankylosing spondylitis (AS) with TNFα blockers, has been shown to result in clinically significant improvement of signs and symptoms of the disease. Long-term extension studies with these agents have shown sustained clinical efficacy for up to 10 years in patients who continued treatment. However, only a few studies have examined whether reduction of dosage of discontinuation of anti-TNF therapy is possible. In daily clinical practice, prolongation of treatment intervals is frequently tried in patients who are in clinical remission for longer periods of time, but no data on the success of that are available. Discontinuation of treatment is usually needed in patients who want to become pregnant, and in patients with severe infections. This review summarises what is known on the topic of discontinuation of biologic treatment in patients with AS.