TY - JOUR T1 - Challenges and Advances in Targeting Remission in Axial Spondyloarthritis JF - The Journal of Rheumatology JO - J Rheumatol SP - 153 LP - 157 DO - 10.3899/jrheum.170222 VL - 45 IS - 2 AU - XENOFON BARALIAKOS AU - FRANCIS BERENBAUM AU - ENNIO GIULIO FAVALLI AU - IGNAZIO OLIVIERI AU - BENEDIKT OSTENDORF AU - DENIS PODDUBNYY AU - KURT DE VLAM Y1 - 2018/02/01 UR - http://www.jrheum.org/content/45/2/153.abstract N2 - Biologic therapies have vastly improved clinical outcomes for patients with axial spondyloarthritis (axSpA). Consequently, targeting clinical remission/inactive disease is now a major treatment goal as outlined in current treat-to-target recommendations1,2. In March 2016, the current status of treating to target and aiming for remission in axSpA was reviewed by 7 expert rheumatologists and 1 patient representative at an industry-sponsored roundtable discussion. This editorial summarizes the key findings from the meeting and recommendations for future research.At present, there is no clear, universally accepted definition of remission in axSpA for both clinical trials and routine practice. Clinical remission/inactive disease is defined by the absence of clinical and laboratory evidence of significant inflammatory disease activity in current treat-to-target recommendations1,2; however, it remains unclear how to precisely assess this in practice. Various criteria to measure low disease activity (LDA) and clinical remission have been proposed that while potentially serving as realistic treatment goals in a treat-to-target strategy, require further validation in the clinical setting3,4. In 2001, the Assessment of Spondyloarthritis international Society (ASAS) developed a preliminary definition of clinical remission—ASAS partial remission (ASAS PR), which includes assessment of 4 domains: patient global, spinal pain, physical function, and “inflammation” (a proxy for true inflammation, based on morning stiffness)5. In clinical trials, 12–15%5,6 of patients with ankylosing spondylitis (AS) receiving nonsteroidal antiinflammatory drugs (NSAID) achieve partial remission; a ceiling of ∼15–40% at 6 months also exists with biologic therapies, including tumor necrosis factor (TNF) inhibitors and secukinumab7,8 (Table 19–20). Treating patients with short symptom duration may increase the proportion of patients reaching clinical remission to ∼50%9,21,22.View this table:In this windowIn a new windowTable 1. Achievement of ASAS partial remission and ASDAS inactive disease with … Address correspondence to Dr. X. Baraliakos, Associate Professor, Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Claudiusstr. 45, 44649 Herne, Germany. E-mail: xenofon.baraliakos{at}elisabethgruppe.de ER -