ArticleArthritis research & therapy2019
Biological treatment of ankylosing spondylitis: a nationwide study of treatment trajectories on a patient level in clinical practice.
Article in Arthritis research & therapy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- An Overview of Adalimumab Therapy for Ankylosing Spondylitis.Current rheumatology reviews · 2024Pooled it
- Phase II randomised, placebo-controlled study to evaluate the efficacy and safety of an MK2 inhibitor in ankylosing spondylitis.RMD open · 2026Trial
- Efficacy and safety of subcutaneous golimumab in Syrian patients with ankylosing spondylitis: A cohort study.The Journal of international medical research · 2026Observational
- Real-World Retention Rate, Effectiveness, and Safety of Netakimab in the Treatment of Patients with Ankylosing Spondylitis: Two-Year Results of the Real Word Evidence LIBRA Study.Doklady. Biochemistry and biophysics · 2026Article
- Difficult to manage axial spondyloarthritis patients have high burden of pain-related comorbidities and adverse long-term outcome.Arthritis research & therapy · 2026Article
- Real-world drug survival and treatment outcome of ixekizumab in patients with spondyloarthropathies.Frontiers in immunology · 2026Article
- Global research trends in biological therapy for ankylosing spondylitis: A comprehensive visualization and bibliometric study (2004-2023).Human vaccines & immunotherapeutics · 2025Article
- Long-term comparative analysis of secukinumab versus TNFα inhibitors in patients with spondyloarthritis: treatment persistence is differentially affected by disease phenotype, obesity and sex.Arthritis research & therapy · 2025Article
- Which are the clinical characteristics that lead to the decision of primary or secondary usage of TNFi or IL-17i in patients with axial spondyloarthritis?: Real-world evidence from the RABBIT-SpA cohort.EULAR rheumatology open · 2025Article
- Real-World Retention Rate, Effectiveness, and Safety of Netakimab in the Treatment of Patients with Ankylosing Spondylitis: First Year Results of the LIBRA Post-Registration Safety Study.Doklady. Biochemistry and biophysics · 2024Observational
- Current Status of Biological Treatment in Ankylosing Spondylitis Patients and Some Related Factors.Materia socio-medica · 2023Article
- Tumor necrosis factor inhibitor (TNFi) persistence and reasons for discontinuation in a predominantly male cohort with axial spondyloarthritis.Rheumatology international · 2022Observational
- Pregnancy outcomes in women with ankylosing spondylitis: a scoping literature and methodological review.Clinical rheumatology · 2021Article
- Immunological Changes in Peripheral Blood of Ankylosing Spondylitis Patients during Anti-TNF-Journal of immunology research · 2021Observational
- Factors affecting drug survival of an alternative TNF inhibitor and secukinumab in patients with ankylosing spondylitis switching from the first TNF inhibitor.Therapeutic advances in musculoskeletal disease · 2021Article
- Predicting response to anti-TNFα therapy among patients with axial spondyloarthritis (axSpA): results from BSRBR-AS.Rheumatology (Oxford, England) · 2020Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundThere is substantial evidence that patients with ankylosing spondylitis (AS) have high response rates to tumour necrosis factor inhibitors (TNFi), a low likelihood of successful treatment termination, but yet a limited drug retention. Whereas several reports have assessed drug retention rates for TNFi in AS, there are few, if any, studies investigating the actual treatment trajectories on a patient level, including subsequent therapy changes and dose reductions, of individual patients. The aim of this study was to describe 5-year treatment trajectories in patients with ankylosing spondylitis (AS) starting a first TNFi.
methodsBio-naïve patients with AS starting a TNFi in 2006-2015 were identified in the nationwide Swedish Rheumatology Quality register and followed until 31 December 2015. All changes in their anti-rheumatic treatment during follow-up were recorded. To further increase precision, these data were complimented by information on the amount of prescribed subcutaneous TNFi collected from pharmacies during each year, retrieved from the Swedish Prescribed Drug Register.
resultsTwo thousand five hundred ninety patients started a first TNFi 2006-2015, and after 1 year, 74% remained on their first TNFi. However, 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 discontinuing the first TNFi, 46% switched directly to a second TNFi, but the drug retention for the second and third TNFi grew successively shorter compared to that for the first TNFi. In contrast, patients remaining on treatment with their first subcutaneous TNFi gradually reduced the dose, so that during the fifth year of treatment only 66% had collected ≥ 75% of the defined daily doses for that year.
conclusionLess than half of patients with AS will remain on their first TNFi after 5 years, but most are still on a biologic. While patients remaining on treatment with their first TNFi appear to be able to reduce the dose over time, a large proportion cycle through several biologics, and 1/3 have no anti-rheumatic treatment after 5 years. This indicates the importance of thorough follow-up programs as well as a need for alternative therapeutic options.
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