Withdrawal of biologic therapy in axial spondyloarthritis: the experience in early disease.

Tumour necrosis factor-alpha inhibitors (TNF-blockers) are recommended for the treatment of predominantly axial spondyloarthritis (SpA), after failure of non-steroidal anti-inflammatory drugs (NSAIDs). TNF-blockers are very effective drugs and also show a sustained and stable long-term response in axial SpA. A few trials indicated that withdrawal of TNF-blockers in longstanding ankylosing spondylitis (AS) is not feasible. However, a recent trial in very early axial SpA suggests that reaching a state of biologic-free low disease activity may be a realistic goal in some patients. This review summarises the available data concerning withdrawal of biologic therapies in early axial SpA.