Maintenance of biologic-free remission with naproxen or no treatment in patients with early, active axial spondyloarthritis: results from a 6-month, randomised, open-label follow-up study, INFAST Part 2. 

Sieper J. et al. Ann Rheum Dis 2014;73:108-113

Authors’ question was if biologic-free remission can be achievable in patients with early, active spondyloarthritis who were in partial remission after 28 weeks of treatment with infliximab+naproxen and if treatment with naproxen was superior to no treatment to maintain remission.

Patients with active, early, moderate-severe spondyloarthritis were treated with infliximab+naproxen for 28 weeks vs placebo+naproxen (INFAST trial). Those who achieved partial remission at the 28th week were randomized to continue with naproxen or no treatment.

After 52 weeks 47.5% of patients in naproxen group and 40% in no treatment group maintained partial remission. Median duration of partial remission in naproxen group was 23 weeks and 12 weeks in no treatment group.

Authors concluded that about half of the patients who achieved partial remission after treatment with infliximab+naproxen or naproxen alone, remained in remission at 6 months (on naproxen or no treatment).