Rheumatology Centre, Toulouse University Hospital, Centre d'Investigation Clinique de Toulouse CIC1436, Inserm, University of Toulouse 3, Toulouse, France.
Service de pharmacologie médicale et clinique, unité MéDatAS-CIC, CIC 1436, centre hospitalier universitaire de Toulouse, University of Toulouse 3, Toulouse, France.
Joint Bone Spine. 2022 Jul;89(4):105358. doi: 10.1016/j.jbspin.2022.105358. Epub 2022 Feb 12.
To assess the frequency of patients in drug-free remission at 5 years in a cohort of early axial SpA, and the factors associated with this remission.
Patients: patients included in the DESIR (DEvenir des Spondyloarthropathies Indifférenciées Récentes) cohort undergoing the 5-year visit were selected for this analysis. Definition of 5-year drug-free remission: (1) all patients in ASAS partial remission and/or ASDAS<1.3 at 5 year visit and (2) taking no disease modifying anti-rheumatic drugs at the 5-year visit and (3) with an ASAS-NSAID score≤25 at the 5-year visit.
the proportion of patients in drug-free remission was described. The association between demographic, clinical, biological and imaging characteristics and drug-free remission at 5 years was assessed by logistic regression.
Of the 412 patients included in this analysis, 73 (18%) were in drug-free remission at the 5-year visit. The baseline clinical factors associated with the chances to be in drug-free remission at the 5-year visit were symptom duration (OR=0.66 [95%CI%: 0.44-0.97]), lower HAQ-AS score (OR=0.32 [0.12-0.78]), lower ASDAS score (OR=0.55 [95%CI: 0.34-0.86]), ASAS-NSAID score (OR=0.91 [95%CI: 0.82-0.99]). Furthermore, anti-TNF use (OR=0.20 [95%CI: 0.08-0.42]) during the follow-up decreased the chances of being in 5-year drug-free remission.
The probability of being in drug free remission at 5 year when beginning an axial SpA is low and is associated with lower baseline disease activity and functional scores, while starting an anti-TNF is associated with poor chances of later being in drug-free remission. NCT01648907.
评估一组早期中轴型脊柱关节炎患者在 5 年内无药物缓解的频率，并分析与该缓解相关的因素。
患者：从 DESIR（近期未分化脊柱关节炎的转归）队列中选择接受 5 年随访的患者进行此项分析。5 年无药物缓解的定义：（1）所有患者在 5 年时达到 ASAS 部分缓解和/或 ASDAS<1.3，（2）在 5 年时未服用任何疾病修正抗风湿药物，（3）在 5 年时 ASAS-NSAID 评分为≤25。
描述无药物缓解患者的比例。通过逻辑回归评估人口统计学、临床、生物学和影像学特征与 5 年无药物缓解的相关性。
在纳入本分析的 412 名患者中，73 名（18%）在 5 年时处于无药物缓解状态。与 5 年时无药物缓解相关的基线临床因素包括症状持续时间（OR=0.66[95%CI%：0.44-0.97]）、较低的 HAQ-AS 评分（OR=0.32[0.12-0.78]）、较低的 ASDAS 评分（OR=0.55[95%CI：0.34-0.86]）和 ASAS-NSAID 评分（OR=0.91[95%CI：0.82-0.99]）。此外，在随访期间使用抗 TNF（OR=0.20[95%CI：0.08-0.42]）降低了 5 年无药物缓解的几率。
在开始中轴型脊柱关节炎时，5 年无药物缓解的概率较低，与较低的基线疾病活动度和功能评分相关，而开始使用抗 TNF 与以后无药物缓解的机会较差相关。NCT01648907。
