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Anti-TNF-induced remission in very early peripheral spondyloarthritis : the CRESPA study

(2017) ANNALS OF THE RHEUMATIC DISEASES. 76(8). p.1389-1395
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Abstract
Objective: To evaluate the efficacy and safety of golimumab to induce clinical remission in patients with very early, active peripheral spondyloarthritis (pSpA). Methods: Clinical REmission in peripheral SPondyloArthritis is a monocentric study of golimumab treatment in patients with pSpA. All patients fulfilled the Assessment of SpondyloArthritis international Society classification criteria for pSpA, with a symptom duration <= 12 weeks. Patients were randomised 2: 1 to receive golimumab 50 mg every 4 weeks or matching placebo for 24 weeks. The primary end point was the percentage of patients achieving clinical remission at week 24, defined as absence of arthritis, enthesitis and dactylitis. Secondary end points included joint and enthesis counts, patient-reported outcomes, erythrocyte sedimentation rate and C reactive protein. From week 12, non-responders were allowed to receive rescue medication with golimumab. Adverse events were recorded. Results: 60 patients were randomised with similar baseline characteristics. At week 24, a significantly higher percentage of patients receiving golimumab achieved clinical remission compared with placebo (75% (30/40) vs 20% (4/20); p<0.001). At week 12, similar results were observed (70% (28/40) vs 15% (3/20); p<0.001). All secondary end points were met at week 24. Rescue medication was necessary in 50% in the placebo group opposed to only 10% in the golimumab arm. Rates of adverse events were low and similar in both groups. Conclusions: Markedly high remission induction rates were noted with golimumab in very early pSpA. Of interest, in placebo-treated patients, very low spontaneous remission rates were observed.
Keywords
PLACEBO-CONTROLLED TRIAL, NONRADIOGRAPHIC AXIAL SPONDYLOARTHRITIS, CHIMERIC MONOCLONAL-ANTIBODY, FACTOR-ALPHA INFLIXIMAB, SHORT-TERM, TREATMENT, DOUBLE-BLIND, ANKYLOSING-SPONDYLITIS, PSORIATIC-ARTHRITIS, EFFICACY, ETANERCEPT

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Chicago
Carron, Philippe, Gaëlle Varkas, Heleen Cypers, Liesbet Van Praet, Dirk Elewaut, and Filip Van den Bosch. 2017. “Anti-TNF-induced Remission in Very Early Peripheral Spondyloarthritis : the CRESPA Study.” Annals of the Rheumatic Diseases 76 (8): 1389–1395.
APA
Carron, P., Varkas, G., Cypers, H., Van Praet, L., Elewaut, D., & Van den Bosch, F. (2017). Anti-TNF-induced remission in very early peripheral spondyloarthritis : the CRESPA study. ANNALS OF THE RHEUMATIC DISEASES, 76(8), 1389–1395.
Vancouver
1.
Carron P, Varkas G, Cypers H, Van Praet L, Elewaut D, Van den Bosch F. Anti-TNF-induced remission in very early peripheral spondyloarthritis : the CRESPA study. ANNALS OF THE RHEUMATIC DISEASES. 2017;76(8):1389–95.
MLA
Carron, Philippe, Gaëlle Varkas, Heleen Cypers, et al. “Anti-TNF-induced Remission in Very Early Peripheral Spondyloarthritis : the CRESPA Study.” ANNALS OF THE RHEUMATIC DISEASES 76.8 (2017): 1389–1395. Print.
@article{8527874,
  abstract     = {Objective: To evaluate the efficacy and safety of golimumab to induce clinical remission in patients with very early, active peripheral spondyloarthritis (pSpA). 
Methods: Clinical REmission in peripheral SPondyloArthritis is a monocentric study of golimumab treatment in patients with pSpA. All patients fulfilled the Assessment of SpondyloArthritis international Society classification criteria for pSpA, with a symptom duration {\textlangle}= 12 weeks. Patients were randomised 2: 1 to receive golimumab 50 mg every 4 weeks or matching placebo for 24 weeks. The primary end point was the percentage of patients achieving clinical remission at week 24, defined as absence of arthritis, enthesitis and dactylitis. Secondary end points included joint and enthesis counts, patient-reported outcomes, erythrocyte sedimentation rate and C reactive protein. From week 12, non-responders were allowed to receive rescue medication with golimumab. Adverse events were recorded. 
Results: 60 patients were randomised with similar baseline characteristics. At week 24, a significantly higher percentage of patients receiving golimumab achieved clinical remission compared with placebo (75\% (30/40) vs 20\% (4/20); p{\textlangle}0.001). At week 12, similar results were observed (70\% (28/40) vs 15\% (3/20); p{\textlangle}0.001). All secondary end points were met at week 24. Rescue medication was necessary in 50\% in the placebo group opposed to only 10\% in the golimumab arm. Rates of adverse events were low and similar in both groups. 
Conclusions: Markedly high remission induction rates were noted with golimumab in very early pSpA. Of interest, in placebo-treated patients, very low spontaneous remission rates were observed.},
  author       = {Carron, Philippe and Varkas, Ga{\"e}lle and Cypers, Heleen and Van Praet, Liesbet and Elewaut, Dirk and Van den Bosch, Filip},
  issn         = {0003-4967},
  journal      = {ANNALS OF THE RHEUMATIC DISEASES},
  language     = {eng},
  number       = {8},
  pages        = {1389--1395},
  title        = {Anti-TNF-induced remission in very early peripheral spondyloarthritis : the CRESPA study},
  url          = {http://dx.doi.org/10.1136/annrheumdis-2016-210775},
  volume       = {76},
  year         = {2017},
}

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