Dosage and Duration of Etanercept Therapy for Ankylosing Spondylitis: A Meta-Analysis

Lee, Heeyoung; Jung, Youn-Joo; Song, Seungyeon; Lee, Jihyung; Shim, Hyunjun; Kang, Wonku; Kim, Eun Young

doi:10.1017/s0266462317000150

Cited by 5 publications

(2 citation statements)

References 31 publications

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“…[8][9][10][11][12][13][14][15][16][17][18][19][20] According to a systemic review and a meta-analysis on etanercept tapering in AS patients, etanercept reduction was effectively comparable with nondecreasing standard dosages in most studies. 25,26 In our study, the flare-free maintenance rates with stepwise tapering of rhTNFR:Fc at week 48 were 91.0% and 83.3% in patients with clinical remission and LDA, respectively. When to start tapering etanercept in AS patients has been inconsistent among recommendations or studies.…”

Section: Discussionmentioning

confidence: 53%

Disease activity guided stepwise tapering or discontinuation of rhTNFR:Fc, an etanercept biosimilar, in patients with ankylosing spondylitis: a prospective, randomized, open-label, multicentric study

Zhang

Zhu

et al. 2020

Therapeutic Advances in Musculoskeletal

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Background: The aim of this study was to evaluate disease-activity-guided stepwise tapering or discontinuation of rhTNFR:Fc, an etanercept biosimilar, in patients with ankylosing spondylitis (AS) in a prospective, randomized, open-label, multicentric study. Methods: Active AS patients with AS disease activity score (ASDAS) ⩾2.1 recruited from 10 hospitals were treated with rhTNFR:Fc 50 mg weekly for 12 weeks, and further randomized into different tapering or discontinuation groups according to ASDAS at week 12. Patients who achieved clinical remission (ASDAS < 1.3) were assigned randomly to stepwise tapering group or discontinuation group. Patients who achieved low disease activity (LDA, 1.3⩽ASDAS < 2.1) were assigned randomly to stepwise tapering, delayed tapering, or discontinuation group. All patients were evaluated every 12 weeks until week 48. The primary endpoint was cumulative flare rates in different groups at week 48. Results: A total of 311 patients were enrolled with an average ASDAS of 3.6 ± 1.0, and 259 completed 12 weeks of rhTNFR:Fc induction therapy, with 148 patients (57.1%) achieved clinical remission, 100 (38.6%) achieved LDA, and 11 (4.3%) remained as high disease activity (ASDAS⩾2.1). In patients who achieved clinical remission at week 12, stepwise tapering of rhTNFR:Fc demonstrated significantly lower flare rates at each evaluation compared with discontinuation. In patients who achieved LDA, there was no significant difference of flare rates between stepwise tapering, delayed tapering, and discontinuation. With stepwise tapering of rhTNFR:Fc, flare rates were comparable in AS patients, irrespective of initial ASDAS before tapering. Conclusion: Stepwise tapering of rhTNFR:Fc when patients achieved clinical remission was able to maintain favorable low flare rates in 48 weeks. LDA was an alternative therapeutic target, as well as an viable timing for initiation of rhTNFR:Fc tapering. rhTNFR:Fc 25 mg monthly maintained flare-free status in a considerable number of patients. However, abrupt discontinuation of rhTNFR:Fc even if patients achieved clinical remission should be avoided. Trial registration: ClinicalTrials.gov: NCT03880968, URL: https://clinicaltrials.gov/ct2/show/NCT03880968

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Section: Discussionmentioning

confidence: 53%

Disease activity guided stepwise tapering or discontinuation of rhTNFR:Fc, an etanercept biosimilar, in patients with ankylosing spondylitis: a prospective, randomized, open-label, multicentric study

Zhang

Zhu

et al. 2020

Therapeutic Advances in Musculoskeletal

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“…В последние годы было проведено несколько исследований по оценке возможности отмены ингибиторов ФНО-α при достижении ремиссии или низкой активности у больных аксиальным спондилоартритом (аксСпА). При раннем (не рентгенологическом) аксСпА с длительностью заболевания до 3 лет частота сохранения низкой активности в течение 6-12 месяцев после отмены инфликсимаба, адалимумаба и этанерцепта варьировала от 23 до 94% [12,[16][17][18][19]. Результаты исследований, оценивающих возможность сохранения низкой активности аксСпА без применения ингибиторов ФНО-α у больных с длительным анамнезом заболевания и соответствующих Нью-Йоркским критериям диагноза АС, менее оптимистичны.…”

Section: Discussionunclassified

Possibility of treatment modification in patients with ankylosing spondylitis achieved of partial remission on treatment with adalimumab: Real practice data

Петров

Шевнина

Гаффарова

et al. 2021

Naučno-praktičeskaâ revmatologiâ

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Цель исследования -оценить длительность сохранения ремиссии или статуса неактивного заболевания у больных анкилозирующим спондилитом с частичной ремиссией на фоне лечения адалимумабом (АДА) после его отмены. Материалы и методы. Наблюдались 26 больных с анкилозирующим спондилитом, у которых в результате длительного применения (в течение 24 месяцев и более) АДА в виде подкожных инъекций по 40 мг 1 раз в две недели наблюдалась частичная клиническая ремиссия заболевания. АДА отменялся после 3-4-месячного периода применения в деэскалационном режиме в виде 1 инъекции (40 мг) 1 раз в 4 недели. После отмены АДА больные продолжали принимать нестероидные противовоспалительные препараты, сульфасалазин в дозе 1,5-2 г в сутки (n=11) и метотрексат 10 мг в неделю (n=3). Оценка клинических, лабораторных и ультрасонографических параметров анкилозирующего спондилита проводилась через 3, 6 и 12 месяцев после отмены АДА. Результаты и обсуждение. Через 6 месяцев частичная ремиссия анкилозирующего спондилита сохранялась у 12 (46,2%), а через 12 месяцев -у 10 (38,5%) больных. Низкая активность заболевания (BASDAI <4) отмечена у 14 (53,8%) и 12 (46,2%) больных соответственно. Заключение. В течение 12 месяцев после отмены АДА обострение анкилозирующего спондилита наблюдалось у 53,8% больных с частичной клинической ремиссией. Ключевые слова: анкилозирующий спондилит, частичная клиническая ремиссия, адалимумаб, индекс ASDAS-СРБ, индекс BASDAI Для цитирования: Петров АВ, Шевнина ЯО, Гаффарова АС, Матвеева НВ. Возможности модификации терапии у пациентов с анкилозирующим спондилитом, достигших частичной ремиссии на фоне лечения адалимумабом: данные реальной практики.

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Clinical and MRI response to dose reduction of an etanercept-biosimilar for hip arthritis in patients with ankylosing spondylitis: an observational, retrospective cohort study

et al. 2019

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Dosage and Duration of Etanercept Therapy for Ankylosing Spondylitis: A Meta-Analysis

Abstract: Our meta-analysis found that there was no significant efficacy difference between 50 mg once-weekly and 25 mg twice-weekly dosing for the treatment of AS, and a dosing duration of less than 12 weeks was more effective for treating AS patients.

Cited by 5 publications

References 31 publications

Disease activity guided stepwise tapering or discontinuation of rhTNFR:Fc, an etanercept biosimilar, in patients with ankylosing spondylitis: a prospective, randomized, open-label, multicentric study

Disease activity guided stepwise tapering or discontinuation of rhTNFR:Fc, an etanercept biosimilar, in patients with ankylosing spondylitis: a prospective, randomized, open-label, multicentric study

Possibility of treatment modification in patients with ankylosing spondylitis achieved of partial remission on treatment with adalimumab: Real practice data

Clinical and MRI response to dose reduction of an etanercept-biosimilar for hip arthritis in patients with ankylosing spondylitis: an observational, retrospective cohort study

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