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A study of biologic-naïve patients with ankylosing spondylitis (AS) who started therapy with a tumour necrosis factor inhibitor (TNFi) shows that after 5 years only 46% are still on a TNFi and that some are able to lower the dose over time.
A nationwide Swedish Rheumatology register followed 2590 Bio-naïve AS who started a TNFi between 2006–2015.
At 1 year, 74% were still on their first TNFi. After 5 years, this figure was only 46%, although at that time 63% were still on treatment with any biologic, while 30% had no anti-rheumatic treatment at all.
After stopping the first TNFi, 46% switched to a second TNFi, but the drug retention for the second and third TNFi grew successively shorter compared to that for the first TNFi.
For those who remained on their first TNFi, many gradually reduced the dose; by year 5 only 66% had collected ≥ 75% of the defined daily doses for that year.
Two-thirds of AS patients stay on a TNFi (at the same or reduced dose) or cycle through other biologics. One-third are not on anti-rheumatic treatment after 5 years.