Patients with psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) may taper off tumor necrosis factor inhibitors (TNFi) safely and effectively and still maintain disease control for up to 2 years, according to an abstract presented at the ACR Convergence in San Diego on November 12.

The DRESS-PS study 1 demonstrated that a treat-to-target (T2T) tapering strategy in PsA and axSpA patients is noninferior compared to T2T without tapering while maintaining low disease activity (LDA) at 12 months. The extension of the DRESS-PS study examines the effects up to 2 years.

The 12-month observational extension of the DRESS-PS study evaluated the treatment decisions according to usual care and T2T tapering for all patients. Patients visited the outpatient clinic biannually.

The primary outcomes were disease activity (presented as proportion of patients in LDA and mean disease activity), and TNFi use (presented as percentage of the current daily dose to the defined daily dose [DDD]). The secondary outcomes were functions measured with the Health Assessment Questionnaire-Disability Index and the Bath Ankylosing Spondylitis Functional Index and quality of life as measured with EQ5D, the 12-item Short Form survey and ASAS-Health Index at 24 months.

The extension study included 114 patients (of the original 122 in study 1).

“The proportion in low disease activity state at 24 months was 67% (45 of 67) in patients originally allocated in the intervention group and 72% (23 of 32) in patients originally allocated in the control group,” the investigators reported.

Mean disease activity remained stable during the extension period. Functioning and quality of life at 24 months was similar between patients originally randomized to intervention and control group.

“Whether this is by chance or caused by a disease-specific need for higher dosing or more subjective disease activity measures, remains a topic for further research,” the authors concluded.

Reference:
Peeters A, Michielsens CAJ, Mahler E et al. 0775: Effectiveness of dose reduction and withdrawal strategies of TNF inhibitors in psoriatic arthritis and axial spondyloarthritis: Long term extension of the DRESS-PS study. Presented at: American College of Rheumatology Convergence. November 12, 2023. San Diego.