10-year follow-up of the CRESPA trial, which randomized 60 patients with early peripheral spondyloarthritis (pSpA, symptom duration ≤12 weeks) to golimumab 50mg Q4W or placebo, assessing rates of clinical and drug-free remission and their baseline predictors.
At mean 10.5 years, 81.6% (40/49) of evaluated patients were in clinical remission; 30.6% (15/49) achieved drug-free remission. Notably, 48.1% (13/27) of non-psoriatic pSpA patients were in drug-free remission vs. patients with baseline psoriasis (OR 9.1; 95% CI 1.8–50). Remission was not predicted by sex, age, HLA-B27, or initial treatment assignment.
Only 49 of 60 original patients completed the 10-year evaluation, introducing potential attrition bias. The study is descriptive with a small sample, limiting power for subgroup analyses. Full-text data were not available; findings rely on the abstract and results sections only.
Early, intensive TNF-inhibitor therapy in pSpA can yield sustained clinical remission in most patients and drug-free remission in roughly one-third — rising to nearly half in those without baseline psoriasis. Clinicians should consider aggressive early treatment and may find psoriasis at baseline a useful marker for lower likelihood of drug-free remission.
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