LAUSR

OBJECTIVES To assess the frequency of patients in drug-free remission at 5 years in a cohort of early axial SpA, and the factors associated with this remission. METHODS Patients: Patients included in the DESIR (DEvenir des Spondyloarthropathies Indifférenciées Récentes) cohort undergoing the 5-year visit were selected for this analysis. Definition of 5-year drug-free remission: 1/ all patients in ASAS partial remission and/or ASDAS<1.3 at 5 year visit and 2/ taking no disease modifying anti-rheumatic drugs at the 5-year visit and 3/ with an ASAS-NSAID score≤25 at the 5-year visit. DATA ANALYSIS The proportion of patients in drug-free remission was described. The association between demographic, clinical, biological and imaging characteristics and drug-free remission at 5 years was assessed by logistic regression. RESULTS Of the 412 patients included in this analysis, 73 (18%) were in drug-free remission at the 5-year visit. The baseline clinical factors associated with the chances to be in drug-free remission at the 5-year visit were symptom duration (OR=0.66[95%CI%:0.44-0.97]), lower HAQ-AS score (OR=0.32 [0.12-0.78]), lower ASDAS score (OR=0.55[95%CI:0.34-0.86]), ASAS-NSAID score (OR=0.91[95%CI:0.82-0.99]). Furthermore, anti-TNF use (OR=0.20 [95%CI:0.08-0.42]) during the follow-up decreased the chances of being in 5-year drug-free remission. CONCLUSION The probability of being in drug free remission at 5 year when beginning an axial SpA is low and is associated with lower baseline disease activity and functional scores, while starting an anti-TNF is associated with poor chances of later being in drug-free remission. NCT01648907.