THU0358 Constant Clinical Response in Patients with Early Axial Spondyloarthritis after Continuous Treatment with Etanercept - 4 Year Data of the Esther Trial
Authors: I.-H. Song, K.-G. Hermann, H. Haibel, C. E. Althoff, D. Poddubnyy, J. Listing, A. Weiß, E. Lange, B. Freundlich, M. Rudwaleit, J. Sieper
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Objectives</h3> In patients with early axial spondyloarthritis (SpA) with a disease duration of &lt; 5 years and evidence of active inflammation on whole-body magnetic resonance imaging in the spine and/or sacroiliac-joints at baseline [1] the efficacy of etanercept (ETN) was assessed over three years. <h3>Methods</h3> In the ESTHER trial axial SpA patients were treated with ETN (n= 40) versus sulfasalazine (SSZ) (n= 36) in the first year [1]. After the first year all patients who entered the second treatment year (n= 60) were treated with ETN including 26 patients from the former SSZ group and 22 patients from the former ETN group [2]. Additionally, patients who flared after drug withdrawal at year one and were (re-)treated with ETN (n=12) were also included in this 3 year analysis. Analysis of these 60 patients was performed according to an intention-to-treat analysis which included data for all patients who were still in the study at the beginning of the second year. The four patients who dropped out of the study after the first year in drug-free remission were not counted. <h3>Results</h3> In the pooled group which was treated over 3 years of ETN (n= 60) the BASDAI decreased from 5.7 (standard deviation 1.3) to 2.6 (2.3), the ASDAS from 3.4 (0.7) to 1.3 (0.6) using an intention to treat analysis. ASAS partial remission after three years was reached by 37%, ASDAS inactive disease by 50% (table 1). 40 of these 60 patients (67%) completed the 3 years of continuous ETN treatment. <h3>Conclusions</h3> There was a constant and sustained clinical response in patients with early axial SpA patients treated with ETN over 3 years. The response in this early axial SpA cohort seems to be better compared to established AS cohorts with a longer disease duration (&gt; 10 years) where BASDAI50 response rates of 47% after 3 years of infliximab treatment [3] and ASAS partial remission rates of 27% after 4 years of ETN treatment [4] were reported. <h3>References</h3> Song I.-H. et al. Ann Rheum Dis. 2011;70(4):590-596. Song I.-H. et al. Ann Rheum Dis. 2012;71(7):1212-1215. Braun J. et al. Rheumatology 2005;44:670–676 Davis JC et al. Ann Rheum Dis. 2008;67(3):346-353 <h3>Disclosure of Interest</h3> I.-H. Song Speakers bureau: Pfizer/Wyeth Pharmaceuticals, Merck Sharp Dohme/Schering Plough, Abbott Immunology Pharmaceuticals: consulting fees or other remuneration, K.-G. Hermann: None Declared, H. Haibel Speakers bureau: Pfizer/Wyeth Pharmaceuticals, Merck Sharp Dohme/Schering Plough, Abbott Immunology Pharmaceuticals: consulting fees or other remuneration, C. Althoff: None Declared, D. Poddubnyy Speakers bureau: Pfizer/Wyeth Pharmaceuticals, Merck Sharp Dohme/Schering Plough, Abbott Immunology Pharmaceuticals: consulting fees or other remuneration, J. Listing: None Declared, A. Weiß: None Declared, E. Lange Employee of: employee from Pfizer, Germany, B. Freundlich Employee of: former employee from Pfizer, M. Rudwaleit Speakers bureau: Pfizer/Wy eth Pharmaceuticals, Merck Sharp Dohme/Schering Plough, Abbott Immunology Pharmaceuticals, UCB: consulting fees or other remuneration, J. Sieper Grant/research support from: research grant from Pfizer/Wyeth, Abott, Speakers bureau: Pfizer/Wy eth Pharmaceuticals, Merck Sharp Dohme/Schering Plough, Abbott Immunology Pharmaceuticals, UCB: consulting fees or other remuneration