Early therapeutic interventions in inflammatory rheumatic diseases have proven successful in inducing drug-free remission, and EULAR - The European Alliance of Associations for Rheumatology - recommends early intervention in arthritis, since conventional synthetic disease-modifying antirheumatic drugs (csDMARD) have been shown to slow disease progression in both rheumatoid and psoriatic arthritis. Even though early therapeutic interventions have proven successful in inducing drug-free remission in other inflammatory rheumatic diseases, such studies remain difficult to conduct in axial spondyloarthritis (axSpA), which manifests itself by insidious onset inflammatory back pain. As a result it is often diagnosed late, and a consensus definition of early disease was only recently published.
At the 2024 EULAR congress, Łukasik and colleagues shared data from their prospective study evaluating the efficacy of a tight control, treat-to-target approach in newly diagnosed, treatment-naïve axSpA patients - following the ASAS-EULAR disease management recommendations. Patients were treated with two different non-steroidal anti-inflammatory drugs (NSAID) at optimal doses for a period of at least 4 weeks, but if they did not achieve clinically important improvement, then monotherapy with golimumab was started. Patients were followed until achieving sustained clinical remission - defined as ASDAS-CRP inactive disease state at two consecutive visits with at least 12 weeks interval - or th.
