CRESPA Follow-Up Finds Drug-Free Remission in 31% of Evaluated Patients at 10 Years

A descriptive follow-up of the CRESPA trial, published in Arthritis & Rheumatology, assessed long-term remission in patients with early peripheral spondyloarthritis, including psoriatic arthritis. The original trial randomized patients meeting ASAS peripheral spondyloarthritis classification criteria, with symptoms lasting no more than 12 weeks, to golimumab 50 mg every four weeks or placebo. All 60 original participants were invited for a standardized 10-year evaluation. Clinical remission was defined as absence of swollen joints, enthesitis, or dactylitis.

At a mean follow-up of 10.5 years, 49 patients were evaluated. Forty patients (81.6%) were in clinical remission, including 15 (30.6% of those evaluated) with longstanding drug-free remission. Clinical remission was not associated with baseline sex, age, HLA-B27 status, psoriasis, or initial treatment allocation. Absence of baseline psoriasis was associated with drug-free remission (odds ratio 9.1; 95% CI 1.8–50); 13 of 27 patients with nonpsoriatic disease (48.1%) remained in drug-free remission. Patients in remission had significantly better health-related quality of life and physical function.

The findings document durable disease control in a subset of patients presenting very early. However, the descriptive follow-up does not establish that initial golimumab treatment caused long-term remission. Interpretation is limited by the small sample, 11 participants not evaluated, and the wide confidence interval for the psoriasis association. Full-text details were unavailable.