A real-world study published in the journal Rheumatology and Therapy provides insight into the clinical characteristics of patients with ankylosing spondylitis (AS) who discontinue treatment with tumor necrosis factor inhibitors (TNFis).

To compare the characteristics of patients who discontinued TNFis with those who did not, researchers used the Corrona PsA/SpA Registry to identify patients with AS who were on a TNFi and had ≥2 follow-up visits. A total of 155 patients were included in the analysis; 23.9% (N=37) had discontinued therapy by the second follow-up visit (mean follow-up was 17.8 months).

Results showed that compared with patients who continued TNFi treatment, those who discontinued therapy were older (52.1 years vs. 46.6 years; P=.04), had higher body mass index, and were more likely to be obese at baseline (60% vs. 34%; P<.001). In addition, patients who discontinued TNFis had higher disease activity at baseline compared with those who continued treatment (Bath Ankylosing Spondylitis Disease Activity Index: 4.8 vs. 3.5; Bath Ankylosing Spondylitis Functional Index scores: 4.2 vs. 2.8; P=0.01 for both).

Of the 37 patients who discontinued their index TNFi, 65% switched to a different biologic. Lack of effect, side effects, social reasons, and “doing well” were among the 19 provider-reported reasons for discontinuing treatment.

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“This study helps to address a knowledge gap by contributing information on the characteristics of patients who discontinue TNFis and the reasons for TNFi discontinuation in the United States,” the authors concluded. “These results may help inform treatment decisions regarding initiating or switching to a TNFi in patients with active AS in US clinical practice.”

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