{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T11:46:37Z","timestamp":1784115997742,"version":"3.55.0"},"reference-count":30,"publisher":"The Journal of Rheumatology","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>The aim of this study was to evaluate rate and predictive factors of loss of remission and disease flare in patients with axial spondyloarthritis (axSpA) receiving antitumor necrosis factor (anti-TNF) treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>In this retrospective multicenter study, patients with axSpA, according to the Assessment of Spondyloarthritis international Society (ASAS) criteria, treated with adalimumab, etanercept, or infliximab with a minimum followup of 12 months and satisfying the ASAS partial remission criteria and\/or Ankylosing Spondylitis Disease Activity Score (ASDAS) inactive disease were studied. Disease flare was defined as a Bath Ankylosing Spondylitis Disease Activity Index score &gt; 4.5 or ASDAS score &gt; 2.5 on at least 1 occasion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>One hundred seventy-four patients with axSpA were studied. After a median [interquartile range (IQR)] followup of 4 years (2\u20136), 37 patients (21.2%) experienced a loss of remission and 28 (16.1% of the whole study group) a disease flare. Median (IQR) duration of remission in patients who lost this status was 1 year (0.625\u20132). Higher median erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) values, continuous nonsteroidal antiinflammatory drug (NSAID) use, and an ASDAS-CRP \u2265 0.8 during the remission period were significantly associated with both loss of remission and disease flare. At the multivariate analysis, continuous NSAID intake (OR 4.05, 95% CI 1.4\u201311.74, p = 0.010) and ESR &gt; 15 (OR 2.90, 95% CI 1.23\u20136.82, p = 0.015) were the only factors predictive of disease reactivation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>In this study, loss of remission and disease flares occurred, respectively, in about 21% and 16% of the patients with axSpA who achieved a state of remission while receiving anti-TNF therapy. Residual disease activity was associated with disease reactivation.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.160363","type":"journal-article","created":{"date-parts":[[2016,6,2]],"date-time":"2016-06-02T03:49:22Z","timestamp":1464839362000},"page":"1541-1546","source":"Crossref","is-referenced-by-count":18,"title":["Predictors of Loss of Remission and Disease Flares in Patients with Axial Spondyloarthritis Receiving Antitumor Necrosis Factor Treatment: A Retrospective Study"],"prefix":"10.3899","volume":"43","author":[{"given":"Ennio","family":"Lubrano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Massimo Perrotta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Manara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"D\u2019Angelo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Addimanda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Ramonda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Punzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignazio","family":"Olivieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Salvarani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Marchesoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2262","published-online":{"date-parts":[[2016,6,1]]},"reference":[{"key":"2018112909360432000_43.8.1541.1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.108233"},{"key":"2018112909360432000_43.8.1541.2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-203201"},{"key":"2018112909360432000_43.8.1541.3","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-202389"},{"key":"2018112909360432000_43.8.1541.4","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-201766"},{"key":"2018112909360432000_43.8.1541.5","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2011.151563"},{"key":"2018112909360432000_43.8.1541.6","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.140811"},{"key":"2018112909360432000_43.8.1541.7","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ket249"},{"key":"2018112909360432000_43.8.1541.8","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200108)44:8<1876::AID-ART326>3.0.CO;2-F"},{"key":"2018112909360432000_43.8.1541.9","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.094870"},{"key":"2018112909360432000_43.8.1541.10","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.138594"},{"issue":"Suppl 43","key":"2018112909360432000_43.8.1541.11","first-page":"S-88","article-title":"Remission in ankylosing spondylitis","volume":"24","author":"Zochling","year":"2006","journal-title":"Clin Exp Rheumatol"},{"key":"2018112909360432000_43.8.1541.12","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204231"},{"key":"2018112909360432000_43.8.1541.13","first-page":"2286","article-title":"A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index","volume":"21","author":"Garrett","year":"1994","journal-title":"J Rheumatol"},{"key":"2018112909360432000_43.8.1541.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2013.01.003"},{"key":"2018112909360432000_43.8.1541.15","first-page":"954","article-title":"Definition of disease flare in ankylosing spondylitis: the patients\u2019 perspective","volume":"29","author":"Brophy","year":"2002","journal-title":"J Rheumatol"},{"key":"2018112909360432000_43.8.1541.16","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kep435"},{"key":"2018112909360432000_43.8.1541.17","first-page":"1694","article-title":"Defining spinal mobility in ankylosing spondylitis (AS). 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