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      Treat-to-target dose reduction and withdrawal strategy of TNF inhibitors in psoriatic arthritis and axial spondyloarthritis: a randomised controlled non-inferiority trial.

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          Abstract

          Tumour necrosis factor inhibitors (TNFi) are effective in psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA), but are associated with a small (0.6%) increase in serious infection risk, patient burden due to need for self-injection and high costs. Treat-to-target (T2T) tapering might ameliorate these drawbacks, but high-quality evidence on T2T tapering strategies is lacking in PsA and axSpA.

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          Most cited references26

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          Risk of serious infection in biological treatment of patients with rheumatoid arthritis: a systematic review and meta-analysis.

          Jasvinder Singh, Chris Cameron, Shahrzad Noorbaloochi … (2015)
          Serious infections are a major concern for patients considering treatments for rheumatoid arthritis. Evidence is inconsistent as to whether biological drugs are associated with an increased risk of serious infection compared with traditional disease-modifying antirheumatic drugs (DMARDs). We did a systematic review and meta-analysis of serious infections in patients treated with biological drugs compared with those treated with traditional DMARDs.
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            European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2015 update.

            L Gossec, J S Smolen, S Ramiro … (2016)
            Since the publication of the European League Against Rheumatism recommendations for the pharmacological treatment of psoriatic arthritis (PsA) in 2012, new evidence and new therapeutic agents have emerged. The objective was to update these recommendations.
            Article 0 comments Cited 119 times – based on 0 reviews     Review now
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              Deciding on progression of joint damage in paired films of individual patients: smallest detectable difference or change.

              W Van der Pol, P Kostense, Debby Van Dam … (2005)
              Progression of radiological joint damage is usually based on the simultaneous assessment of a series of films from an individual patient ("paired", with or without known sequence). In this setting the degree of progression that can be reliably detected above the measurement error is best determined by the smallest detectable change, and overestimated by the traditionally calculated smallest detectable difference. This knowledge is important for calculation of the proportion of patients showing radiographic progression in clinical trials.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): Ann Rheum Dis
                Title: Annals of the rheumatic diseases
                Publisher: BMJ
                ISSN (Electronic): 1468-2060
                ISSN (Print): 0003-4967
                Publication date (Electronic): Oct 2022
                Volume: 81
                Issue: 10
                Affiliations
                [1 ] Rheumatology, Sint Maartenskliniek, Nijmegen, Gelderland, The Netherlands celiamichielsens@gmail.com.
                [2 ] Department of Rheumatic Diseases, Radboudumc Radboud Institute for Health Sciences, Nijmegen, Gelderland, The Netherlands.
                [3 ] Rheumatology, Sint Maartenskliniek, Nijmegen, Gelderland, The Netherlands.
                [4 ] Radboud Institute for Health Sciences, Department for Health Evidence, group Biostatistics, Radboudumc, Nijmegen, Gelderland, The Netherlands.
                [5 ] Rheumatology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands.
                Article
                Publisher Item ID: annrheumdis-2022-222260
                DOI: 10.1136/annrheumdis-2022-222260
                PubMed ID: 35701155
                SO-VID: 209b346d-ffbd-4b17-adf0-aa5ce8d59572
                History

                Keywords: Arthritis, Psoriatic,Tumor Necrosis Factor Inhibitors,Spondylitis, Ankylosing
                Data availability:
                Keywords: Arthritis, Psoriatic, Tumor Necrosis Factor Inhibitors, Spondylitis, Ankylosing

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