Persistent clinical efficacy and safety of anti-tumour necrosis factor \textgreeka therapy with infliximab in patients with ankylosing spondylitis over 5 years: evidence for different types of response

Background: There is insufficient evidence for the long-term
efficacy and safety of anti-tumour necrosis factor therapy in
patients with ankylosing spondylitis (AS). This is the first report
on the treatment with infliximab over 5 years.Methods: As part of a
multicentre randomised trial, 69 patients with active AS at
baseline (BL) have been continuously treated with infliximab (5
mg/kg i.v. every 6 weeks)---except for a short discontinuation
after 3 years (FU1). The primary outcome of this extension was
remission according to the ASsessment in Ankylosing Spondylitis
(ASAS) criteria at the end of year 5 of the study (FU2).Results: Of
the 43 patients who completed year 3, 42 agreed to continue, 38 of
which (90.5%) finished year 5 (55% of 69 initially). Partial
clinical remission was achieved in 13 of 38 patients (34.2%) at FU1
and FU2. At FU2, the mean Bath Ankylosing Spondylitis Disease
Activity Index (BASDAI) was 2.5±1.9 (BL:6.4, FU1:2.5). BASDAI
values