Covid-19: “Health in all policies” will help protect world from future pandemics, says commission

Objectives Tumour necrosis factor inhibitors (TNFi) are effective in psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA), but associated with a small (0.6%) increase serious infection risk, patient burden due to need for self-injection high costs. Treat-to-target (T2T) tapering might ameliorate these drawbacks, high-quality evidence on T2T strategies is lacking PsA axSpA. Methods We performed pragmatic open-label, monocentre, randomised controlled non-inferiority (NI) trial of TNFi. Patients axSpA using TNFi ≥6 months stable low disease activity (LDA) were included. 2:1 activity-guided or without until withdrawal followed-up 12 months. Primary endpoint was the difference proportion patients having LDA at between groups, compared prespecified NI margin 20%, estimated Bayesian prior. Results 122 (64 58 axSpA) strategy (N=81) (N=41). The 69% 73% no-tapering group: adjusted 5% (Bayesian 95% credible interval: −10% 19%) which confirms considering 20%. mean percentage daily defined dose 53% 91% group month 12. Conclusions A attempt non-inferior regard still months, results substantial reduction use. Trial registration number NL 6771.