La terapia anti-TNF en la espondilitis anquilosante (EA). ¿Es posible suspender el tratamiento?

These data suggest that, as is the case with rheumatoid arthritis (RA), early administration of treatment is essential to obtain a consistent, prolonged response. The new ASAS group classification criteria for axial and peripheral forms could be of great importance in establishing an early diagnosis and treatment that improves the therapeutic expectations of those patients. 6 However, are these data sufficient to consider the possibility of discarding biological therapy in patients with AS? From a logical point of view, it could be thought that suspending the treatment systematically for all patients is not an adequate option, given that only 40%-50% of patients in the early stages and 20%-30% in advanced stages present a consistent clinical response (ASAS partial remission). Various studies have analysed the consequences of systematic suspension of treatment on AS patients; the results, independently of which anti-TNF drug was being used and treatment duration, showed clinical reactivation in the short-medium term in up to 75% of cases after 6 months and in over 90% after 12 months.7,8