Background/Purpose: We aimed to compare the demographic and clinical characteristics of the patients with axial spondyloarthritis (aSpA) receiving standard-dose versus tapered-dose biologic disease-modifying antirheumatic drugs (bDMARD).

Methods: The patients with aSpA who visited the rheumatology outpatient clinics at our hospital between 1 October 2017 and 31 October 2023 were retrospectively analyzed. The patient’s data were collected between 1 December 2023 and 30 November 2024. The demographic and clinical characteristics of the patients were compared between groups.

Results: A total of 251 patients were included in the study, with 105 patients in bDMARD tapered dose group (TDG) and 146 patients in standard dose group (SDG). Compared to SDG, there were more male patients in the TDG (75.2% vs. 57.5%, p=0.004). In the TDG, lower rates of obesity (27.6% vs. 47.9%, p=0.001), chronic disease (55.2% vs. 68.5%, p=0.032), fibromyalgia syndrome (FMS) (1.9% vs. 10.3%, p=0.009), ≥3 different bDMARDs usage (4,8% vs 26%, p=0,000), and nonsteroidal anti-inflammatory drug usage (23,8% vs 48,6%, p=0,000) were found. The TDG had a longer disease duration (median: 152 vs. 130 months, p=0.009), lower erythrocyte sedimentation rate (median: 5 mm/h vs. 8 mm/h, p=0.000), C-reactive protein (median: 3,1 mg/L vs 4,05 mg/L, p=0,033), current ankylosing spondylitis disease activity score-C-reactive protein level (median: 1.2 vs. 1.7, p=0.000), and a higher remission rate (87.6% vs. 58.2%, p=0.000). The most frequently used bDMARD in the TDG was etanercept (31,4%, 25 mg and 50 mg forms), and the second most commonly used was golimumab (%21,9). Compared to other bDMARDs, maintenance duration at the tapered dose of etanercept was longer (median: 102 vs 61 months, p=0.002).

Conclusion: bDMARD tapering was more frequently performed in male patients who do not have obesity, chronic diseases, or FMS. Etanercept was a drug that was most commonly tapered.

Figure 1: Flowchart of the study population selection

Table 1: Comparison of baseline characteristics between the tapered-dose and standard-dose groups

Table 2: Dose, dosing interval, time to dose tapering, duration of treatment at the tapered dose, and total treatment duration of the current bDMARD in patients from the tapered-dose group

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/comparison-of-standard-and-tapered-dose-of-biologic-treatments-in-patients-with-axial-spondyloarthritis/