{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T16:00:22Z","timestamp":1781712022621,"version":"3.54.5"},"reference-count":17,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2022,4,28]],"date-time":"2022-04-28T00:00:00Z","timestamp":1651104000000},"content-version":"unspecified","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,3,30]]},"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To determine the frequency of sustained remission (R) or low diseas activity (LDA) in patients with axial spondyloarthritis (axSpA) undergoing long-term biological therapy and to analyse predictive factors for achieving these outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Prospective, observational cohort study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Spanish hospital.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>Patients with axSpA who initiated biological treatment between 2003 and 2017.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Intervention<\/jats:title>\n                  <jats:p>Assessment of demographic and clinical characteristics at the beginning of treatment and disease activity every 6 months up to a maximum of 2 years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measures<\/jats:title>\n                  <jats:p>Disease activity was measured by Ankylosing Spondylitis Disease Activity Score (ASDAS) and Bath Ankylosing Spondylitis Disease Activity Index and C reactive protein (BASDAI&amp;CRP). Sustained R was defined as ASDAS&lt;1.3 and\/or BASDAI &lt;2 and normal CRP while sustained LDA was defined as ASDAS &lt;2.1 and\/or BASDAI &lt;4 and normal CRP on at least three consecutive visits.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total 186 patients (66.1% men and 75.3% with radiographic sacroiliitis) were included. Overall, 76.8% of patients achieved ASDAS R\/LDA (R53.2%\/LDA23.6%) in at least one visit. Forty per cent (R17.6%\/LDA22.4%) of the patients fulfilled the sustained ASDAS R\/LDA state, whereas only 30.8% maintained this status (R14.8%\/LDA15.9%) according to BASDAI&amp;CRP. In the multivariate analysis, male sex (OR=4.01), younger age at the beginning of biological therapy (OR=0.96) and an HLA*B27 positive status (OR=4.30) were associated with achieving sustained ASDAS R\/LDA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In clinical practice, around one-third of patients on biological disease-modifying antirheumatic drugs achieve a sustained R\/LDA status, but these rates drop to less than one in five when targeting remission, preventing the use of the latter as a feasible target. Male sex, HLA*B27 positivity and younger age at the beginning of biological therapy are the main predictors for achieving sustained R\/LDA.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-057850","type":"journal-article","created":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T21:51:49Z","timestamp":1651269109000},"page":"e057850","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Achievement rate and predictive factors of the recommended therapeutical target in patients with axial spondyloarthritis who remain on biological therapy: a prospective cohort study in Spain"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9119-5330","authenticated-orcid":false,"given":"Diego","family":"Benavent","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Hospital Universitario La Paz, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Franco-G\u00f3mez","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Hospital Universitario La Paz, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3503-9047","authenticated-orcid":false,"given":"Chamaida","family":"Plasencia-Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Hospital Universitario La Paz, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2200-0859","authenticated-orcid":false,"given":"Marta","family":"Novella-Navarro","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Hospital Universitario La Paz, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Bogas","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Hospital Universitario La Paz, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romina","family":"Nieto","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Hospital Provincial de Rosario, Rosario, Santa Fe, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3252-8016","authenticated-orcid":false,"given":"Irene","family":"Monjo","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Hospital Universitario La Paz, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Nu\u00f1o","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Hospital Universitario La Paz, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Villalba","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Hospital Universitario La Paz, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Peiteado","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Hospital Universitario La Paz, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8070-7062","authenticated-orcid":false,"given":"Alejandro","family":"Balsa","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Hospital Universitario La Paz, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4527-852X","authenticated-orcid":false,"given":"Victoria","family":"Navarro-Comp\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Hospital Universitario La Paz, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,4,29]]},"reference":[{"key":"2025101810243424000_12.4.e057850.1","doi-asserted-by":"crossref","first-page":"ii1","DOI":"10.1136\/ard.2008.104018","article-title":"The assessment of spondyloarthritis International Society (ASAS) Handbook: a guide to assess spondyloarthritis","volume":"68 Suppl 2","author":"Sieper","year":"2009","journal-title":"Ann Rheum Dis"},{"key":"2025101810243424000_12.4.e057850.2","doi-asserted-by":"crossref","DOI":"10.1136\/annrheumdis-2016-210770","article-title":"2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis","volume":"76","author":"van der Heijde","year":"2017","journal-title":"Ann Rheum Dis"},{"key":"2025101810243424000_12.4.e057850.3","unstructured":"Ward MM , Deodhar A , Gensler LS , et al . 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